Endocrine Abstracts

Objective: To determine the intraoperative levels of cortisol and thyroid hormones in surgical patients with different sensitivity to pain.

Material and methods: We analyzed the individual sensitivity to pain in 94 people the day before surgery. Patients were ASA 1-2. Age 46±10.2 years. We used a mechanical stimulus (1×5 mm wire with stop) and the visual analogue scale of 10 points (color, grayscale, 10 fields, from light to black). Incentives applied to the base of the thumb. Patients divided into 2 groups, first group - low sensitivity to pain (VAS 1-5). 2nd group - high sensitivity to pain (VAS 6-10). All patients underwent laparoscopic cholecystectomy under general anesthesia. Anesthesia consisted of premedication, induction, myoplegia, intubation, ventilation with a mixture of oxygen supply, nitrous oxide and sevoflurane, anodyne - fentanyl, paracetamol. We used hemodynamic monitoring and ventilation system. Control thyroid hormones (T3, T4, TSH) and cortisol before operation, 3 times during surgery and after surgery. Statistical analysis was performed using the software package Statistica 7.0

Results: In all patients, the level of thyroid hormones remained normal throughout the study period. Not observed any changes of thyroid hormone levels in patients with both high and low sensitivity to pain. Plasma cortisol levels remained within the normal range in 92% of patients. In 8% of the patients (all patients in the second group, the high sensitivity to pain) noted the excess of normal levels of cortisol. After the start of operation of cortisol level was higher than baseline. Intraoperatively, in patients with high sensitivity to pain of the plasma cortisol level was higher than in patients with low sensitivity to pain.

Conclusion: Perioperative levels of thyroid hormones and cortisol most surgical patients remains within the normal range. Patients with high sensitivity to pain was higher cortisol levels after starting operation as compared to the level of cortisol in patients with low sensitivity to pain.