Summary.
There is a paucity of studies assessing changes in measures of human neurotransmission during stressful events, such as surgery. Thirty-five patients without any neurological disorders undergoing knee replacements with spinal bupivacaine anaesthesia and propofol sedation had cerebrospinal fluid (CSF) drawn from a spinal catheter before, three hours after and the morning after surgery. The CSF concentrations of the dopamine metabolite homovanillinic acid (HVA) and the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA), which are related to the activity of the dopaminergic and serotonergic systems of the brain, increased sharply during surgery and reached 188% and 166% of their initial concentrations on the morning after the intervention (p < 0.0001). The CSF concentrations of the norepinephrine metabolite 3-methoxy-4-hydroxyphenylglucol (MHPG) increased modestly (non-significantly) during and after surgery. The HVA/5-HIAA ratios initially increased but returned to the initial level during the night after surgery. We conclude that non-neurological surgery, in this case to the lower limb, is accompanied by a marked central nervous stress response in spite of a spinal blockade.
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Correspondence: Henrik Zetterberg, Department of Psychiatry and Neurochemistry, Sahlgrenska University Hospital/Mölndal, 431 80 Mölndal, Sweden; Henrik Anckarsäter, RPK/UMAS, Sege Park 8A, 205 02 Malmö, Sweden
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Anckarsäter, R., Zetterberg, H., Månsson, JE. et al. Non-neurological surgery results in a neurochemical stress response. J Neural Transm 115, 397–399 (2008). https://doi.org/10.1007/s00702-007-0849-7
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DOI: https://doi.org/10.1007/s00702-007-0849-7