Salivarni kortizol kao periferni biomarker stresa kod hirurških pacijenata

Salivarni kortizol kod hirurških pacijenata

  • Sanja Vicković Medicinski fakultet, Univerzitet u Novom Sadu, Novi Sad, Srbija
  • Ranko Zdravković Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia https://orcid.org/0000-0001-7383-6771
  • Sanja Maričić Prijić Medicinski fakultet, Univerzitet u Novom Sadu, Novi Sad, Srbija
  • Dragan Nikolić Medicinski fakultet, Univerzitet u Novom Sadu, Novi Sad, Srbija
  • Dragana Pap Zavod za zdravstvenu zaštitu studenata, Farmaceutski fakultet, Novi Sad, Srbija
  • Emina Čolak Institut za medicinsku biohemiju, Univerzitetski Klinički Centar Srbije, Beograd, Srbija
  • Snežana Jovičić Farmaceutski fakultet, Univerzitet u Beogradu, Srbija
DOI: https://doi.org/10.5937/jomb0-42011
Ključne reči: postoperativni bol, salivarni kortizol, serumski kortizol, hirurški stres

Sažetak


Uvod: Hirurški stres i bol su uzrok aktivacije hipotalamusno-hipofizno-nadbubrežne osovine. Cilj ove studije bio je da se utvrdi uticaj postoperativnog bola i različitih vidova administracije analgetika na vrednosti kortizola u serumu i salivi, kao i da se utvrdi da li je salivarni kortizol dobar pokazatelj stresa kod hirurških pacijenata.

Metode: Randomizovana kontrolisana studija koja je uključila 60 pacijenata primljenih za elektivnu operaciju aneurizme abdominalne aorte. Pacijenti su metodom slučajnog izbora podeljeni u dve grupe u zavisnosti od modela postoperativne analgezije. Prvu grupu (MI) su činili pacijenti koji su dobijali morfin intermitentno u dozi od 0.1mg/kg/6h s.c. U drugoj grupi (MPCA) su bili pacijenti koji su dobijali morfin takozvanom PCA metodom -  intravenska primena morfina 1 pritisak/1mg, interval 6 minuta.

Rezultati: Intenzitet bola se nije značajno razlikovao do desetog sata nakon operacije. Međutim, u periodu od desetog do osamnaestog sata nakon operacije bol je bio izraženiji u MPCA grupi (P < 0.05). Hemodinamska nestabilnost je bila zastupljenija u grupi MI (40.0% vs 6.7%, P = 0.0048). Serumski kortizol bio je gotovo identičan po grupama (MI 509.4 vs MPCA 511.0 nmol/L, P = 0.1473). Salivarni kortizol je bio viši u grupi MPCA ali razlika nije statistički značajna (47.1 vs 116.3 nmol/L, P = 0.0970).

Zaključak: Naša studija je pokazala da je salivarni kortizol senzitivniji biomarker stresa kod hirurških pacijenata u odnosu na serumski kortizol.

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Objavljeno
2023/02/26
Broj časopisa
Vol. 42 Br. 3 (2023): Journal of Medical Biochemistry
Rubrika
Original paper

Sva prava zadržana (c) 2023 Sanja Vicković, Ranko Zdravković, Sanja Maričić Prijić, Dragan Nikolić, Dragana Pap, Emina Čolak, Snežana Jovičić

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