SURGICAL STRESS AND NEUROENDOCRINE RESPONSES IN INFANTS AND CHILDREN

We studied the stress hormone response to surgery in 42 infants and ch ildren, Plasma levels of the stress hormones ACTH, cortisol, beta-endo rphin and arginine-vasopressin (AW) were determined on three occasions , i.e., one day before surgery, 60 to 90 minutes after skin closure an d on the day after surgery (anesthesia by halothane and nitrous oxide) , We observed an increase in the levels of both ACTH and cortisol in m ost patients after surgery, although there was no correlation between them. Beta-endorphin levels, on the other hand, rose after surgery and correlated significantly with ACTH in 30 patients. A steep rise in AV P levels was found in 84% of the subjects, a phenomenon that could not have been due only to osmotic or cardiovascular stimuli. The values o f all the stress hormones declined and normalized on the day after sur gery, We conclude that routine surgery in infancy or childhood induces a dramatic, albeit transient, stimulation of neuroendocrine stress ho rmones.