Anestesia e Resposta Neuroendócrina e Humoral ao
Estresse Cirúrgico

Renato Mestriner Stocche; Luiz Vicente Garcia; Jyrson Guilherme Klamt

Scientific Article

Anestesia e Resposta Neuroendócrina e Humoral ao Estresse Cirúrgico

Anesthesia and Neuroendocrine and Humoral Responses to Surgical Stress

Renato Mestriner Stocche, Luiz Vicente Garcia, Jyrson Guilherme Klamt

Braz J Anesthesiol, vol.51, n1, p.59-69, 2001

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Resumo

Justificativa e Objetivos - A resposta neuroendócrina e metabólica ao estresse é um mecanismo de defesa do organismo agredido por trauma psicológico, físico ou cirúrgico e tem sido objeto de vários trabalhos científicos. O objetivo deste trabalho é enfocar os aspectos relativos à resposta neuroendócrina-metabólica e imunológica ao trauma cirúrgico, procurando proporcionar conhecimentos para possibilitar a modulação desta resposta através da anestesia. Conteúdo - São apresentados os mecanismos e a fisiopatologia da ativação da resposta neuroendócrina e metabólica, assim como as fases da resposta ao estresse cirúrgico. São abordadas as várias técnicas de anestesia e adjuvantes empregados na modulação da resposta neuroendócrina à cirurgia, desde a consulta pré-anestésica. Conclusões - Devido a alta complexidade dos mecanismos envolvidos e a inexistência de técnicas anestésicas isoladas que sejam capazes de bloquear a resposta neuroendócrina e metabólica a tendência atual é de se utilizar associações de técnicas para se obter melhores resultados.

Palavras-chave

METABOLISMO: estresse cirúrgico

Abstract

Background and Objectives - Neuroendocrine and metabolic response to stress is a defense mechanism of the body injured by psychological, physical or surgical trauma, and has been the subject of several scientific reports. This study aimed at addressing neuroendocrine-metabolic and immune responses to surgical trauma to provide knowledge which would allow such response modulation through anesthesia. Content - Mechanisms and pathophysiology of neuroendocrine and metabolic response activation, as well as surgical stress response stages are presented. Several anesthetic techniques and adjuvants used to modulate neuroendocrine responses are discussed, starting in the preanesthetic evaluation. Conclusions - Due to the extreme complexity of mechanisms involved and the lack of isolated anesthetic techniques able to block neuroendocrine and metabolic responses, the current trend is to associate techniques to obtain better results.

Keywords

METABOLISM: surgical stress

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