Fuentes DZ, López LS, Salazar DM

Language: Spanish
References: 28
Page: 136-146
PDF size: 138.60 Kb.

ABSTRACT

Introduction: Knowledge about the physiological response to the stress caused by surgical trauma determined the choice of an effective treatment for complications in a patient scheduled for elective noncardiac surgery.
Objective: Characterize the response to surgical stress.
Methods: A systematic qualitative study was conducted based on a search in MedLine and PubMed from January 1990 to January 2012. The validated search strategy was restricted to the analysis of published randomized studies to determine the features of perioperative surgical stress.
Results: The hystic lesion triggered the generation of afferent nervous signals, which stimulated the sympathetic-suprarenal axis, as well as the hypothalamo-hypofisiary axis. Surgical wound and ischemic tissue local processes were also important, for they produced metabolic alterations in coagulation, inflammation and immune dysfunctions expressed through both local and systemic responses.
Conclusions: Surgical stress is a situation characterized by an increase in the rate of generation of oxidizing species, free radicals and excited species, and a decrease in the activity of defense systems, resulting in greater concentrations of oxygen active species in a stationary state.

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