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Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2017 December;83(12):1324-31

DOI: 10.23736/S0375-9393.17.11878-X


lingua: Inglese

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 of Surgical Pathophysiology, Copenhagen University, Rigshospitalet, Copenhagen, Denmark; 2 Department of Anesthesiology, Copenhagen University, Rigshospitalet, Copenhagen, Denmark


The immediate postoperative course in the post-anesthesia 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: Glucocorticoids - Postoperative nausea and vomiting - Anesthesia recovery period - Operative surgical procedures

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Publication History

Issue published online: December 20, 2017
Article first published online: June 12, 2017
Manuscript accepted: June 5, 2017
Manuscript revised: April 27, 2017
Manuscript received: December 17, 2016

Per citare questo articolo

Steinthorsdottir KJ, Kehlet H, Aasvang EK. Surgical stress response and the potential role of preoperative glucocorticoids on post-anesthesia care unit recovery. Minerva Anestesiol 2017;83:1324-31. DOI: 10.23736/S0375-9393.17.11878-X

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