Analysis of biomarkers of stress in the perioperative period during surgical treatment for abdominal wall hernias

Abstract

Background. Pain impairs the patient’s quality of life after surgery and, causing a significant stress, affects life expectancy. Many biomarkers (albumin, hemoglobin, glucose level, C-reactive protein) are used to objectively assess stress, but their levels depending on the type of analgesia and their role in predicting the course of the postoperative period have not been fully studied. Aim: to conduct a comparative analysis of biomarkers of stress in patients undergoing surgery for abdominal wall hernias depending on the type of perioperative analgesia. Materials and methods. Sixty-three patients who underwent surgical treatment for abdominal wall hernias took part in the study. They were divided into 3 groups according to the method of anesthesia (general, neuraxial and regional blockades). At different stages of the perioperative period, the dynamics of stress biomarkers such as cortisol and blood glucose was studied. Results. Before the operation, the blood glucose level did not differ significantly in three groups. During the traumatic period of surgical treatment, stress-induced hyperglycemia developed, its level did not depend on the type of anesthesia performed, and 24 hours after the operation, the level of glycemia significantly decreased to normal one. A significant increase in cortisol was registered in group 1. At the same time, on the contrary, the blood cortisol level decreased in patients of groups 2 and 3. After 24 hours, the blood cortisol level decreased to normal values, and in all groups, it was lower than that before surgery. Conclusions. Regardless of the type of anesthetic management, an increase in blood glucose levels was recorded in patients of all three groups during surgical treatment for abdominal wall hernias. Patients undergoing regional abdominal wall blocks had lower levels of stress biomarkers after surgery and 24 hours postoperatively compared to general anesthesia.