SOE 032: Surgical Stress Response

IntroductionYou are anaesthetising a 76-year-old male with colonic adenocarcinoma for right hemicolectomy. He is being managed on the ERAS...

What is the surgical stress response?

A group of complex neuroendocrine and metabolic changes that occur in response to trauma and surgery. The net effect is increased catabolism, substrate mobilisation and retention of salt and...

What are the hormonal sequelae of the stress response?

↑ Secretion Unchanged ↓ Secretion Pituitary Growth Hormone (GH)Adrenocorticotrophic Hormone (ACTH)β-EndorphinProlactinAnti-diuretic hormone (ADH) Thyroid-stimulating hormone (TSH)Luteinizing hormone (LH)Follicle-stimulating hormone (FH) - Adrenal...

What are the metabolic sequelae of the stress response?

Carbohydrate Metabolism Blood glucose concentrations increase after trauma:Stimulated by cortisol and catecholamineDue to increased hepatic glycogenolysis and gluconeogenesisPeripheral glucose utilisation also decreasesIncrease in concentration proportional to the...