Current Concepts in Regional Anaesthesia pp 237-244 | Cite as
The Endocrine-Metabolic Response to Postoperative Pain
Abstract
Surgery represents a noxious stimulus to which the body reacts with both a local inflammatory response and a general response. The general response is characterized by profound endocrine changes leading to increased energy consumption and a shift in flow of substrates from storage to central organs. Although we still have no good explanation for this stress-response to injury, an improved understanding of the physiological changes resulting from anaesthesia and surgery has led to a reduction in postoperative morbidity during the last decades. Concomitantly, there has been an increased interest in techniques which may modify the endocrine-metabolic response to surgery, based upon the hypothesis that a reduction in the physiological changes to injury may also lead to a reduction in various aspects of postoperative morbidity. Diminishment of the trauma response presupposes understanding of the involved release mechanisms, including the relative role of afferent neurogenic stimuli, humoral substances released from the wound, pain stimuli, the influence of heat loss, hypoxemia, hypovolemia, psychological factors etc1.
Keywords
Pain Relief Dorsal Horn Postoperative Morbidity Epidural Analgesia Plasma CortisolPreview
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