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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2017 Jun 12

DOI: 10.23736/S0375-9393.17.11878-X

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

The surgical stress response and the potential role of preoperative glucocorticoids on post-anesthesia care unit recovery

Kristin J., STEINTHORSDOTTIR 1, 2, Henrik KEHLET 1 , Eske K. AASVANG 1, 2

1 Section for Surgical Pathophysiology, Copenhagen University, Rigshospitalet, Copenhagen, Denmark; 2 Department of Anaesthesiology, Copenhagen University, Rigshospitalet, Copenhagen, Denmark


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The immediate postoperative course in the post-anaesthesia care unit (PACU) remains a challenge across surgical procedures. Postoperative pain, sedation/cognitive dysfunction, nausea and vomiting (PONV), circulatory and respiratory problems and orthostatic intolerance constitute the bulk of the difficulties that may delay the postoperative recovery. A common feature in the observed organ dysfunctions is the inflammatory response to surgery during the acute postoperative recovery phase, suggesting that control of inflammation may improve outcomes and reduce complications. This narrative review focuses on our understanding of the inflammatory responses in the acute PACU setting in relation to organ dysfunction and suggests where further research is warranted. The main finding is that current evidence suggests inflammation to potentially impair on almost all organ dysfunctions observed in the post-anesthesia care unit (PACU), but with a scarcity of intervention studies using glucocorticoids to control inflammation. We, therefore, suggest a future research focus on the role of inflammation and effect of glucocorticoids in the PACU setting to improve patient recovery.


KEY WORDS: Glucocorticoid - Steroid - Postoperative - Recovery - Surgery

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Cite this article as

Steinthorsdottir KJ, Kehlet H, Aasvang EK. The surgical stress response and the potential role of preoperative glucocorticoids on post-anesthesia care unit recovery. Minerva Anestesiol 2017 Jun 12. DOI: 10.23736/S0375-9393.17.11878-X

Corresponding author e-mail

Henrik.kehlet@regionh.dk