PEDIATRIC SURGICAL STRESS RESPONSE AND ANESTHESIA
Journal
International Journal of Recent Research in Arts and Sciences
Date Issued
2021
Author(s)
Nancheva-Bogoevska, Andreja
Baloski, Marjan
Abstract
Surgical trauma disturb the body homeostasis by inducing a combination of local response
to tissue injury and generalized activation of systemic metabolic and hormonal pathways via
afferent nerve pathways and the central nervous system. The local inflammatory responses and the
parallel neurohumoral responses are not isolated but linked through complex signaling networks,
some of which remain poorly understood. The stress response to surgical trauma occurs as a
protective mechanism, by activating a series of endocrine, metabolic and immune processes which
prevent disturbance of homeostasis. The magnitude of the response is broadly related to the site of
injury (greater in regions with visceral pain afferents such as abdomen and thorax) and the extent
of the trauma. The stress response to surgical trauma is different in premature, newborns, infants,
and in children approaching puberty is the more similar as in adults. New anesthetic agents
basically do not trigger the endocrine-metabolic response of the body.
Endocrine-metabolic, immune and autonomic responses to surgical trauma can be
modified using regional anesthetics techniques and the use of analgesics in general anesthesia. It
is the duty of each anesthesiologist before the surgery according to the patient and the kind and length of the surgical intervention, to assess which anesthesia technique and which
anesthesiological agents is selected for conducting the operation, in order to provide “stress – free”
anesthesia.
to tissue injury and generalized activation of systemic metabolic and hormonal pathways via
afferent nerve pathways and the central nervous system. The local inflammatory responses and the
parallel neurohumoral responses are not isolated but linked through complex signaling networks,
some of which remain poorly understood. The stress response to surgical trauma occurs as a
protective mechanism, by activating a series of endocrine, metabolic and immune processes which
prevent disturbance of homeostasis. The magnitude of the response is broadly related to the site of
injury (greater in regions with visceral pain afferents such as abdomen and thorax) and the extent
of the trauma. The stress response to surgical trauma is different in premature, newborns, infants,
and in children approaching puberty is the more similar as in adults. New anesthetic agents
basically do not trigger the endocrine-metabolic response of the body.
Endocrine-metabolic, immune and autonomic responses to surgical trauma can be
modified using regional anesthetics techniques and the use of analgesics in general anesthesia. It
is the duty of each anesthesiologist before the surgery according to the patient and the kind and length of the surgical intervention, to assess which anesthesia technique and which
anesthesiological agents is selected for conducting the operation, in order to provide “stress – free”
anesthesia.