Discussion
retardations, trauma, hormone deficiencies, endocrine deficits, injuries, hormone deficiency
HORMONE DEFICIENCY, CARDIOVASCULAR DISEASE, POSTOPERATIVE COMPLICATIONS
This study demonstrated that GA impacted on the hormone levels of pediatric patients undergoing CP resection, especially intraoperatively. Compared with sevoflurane, propofol might inhibit the secretion of these hormones more obviously. However, the inhibition effects of the two anesthetics were close to similar level postoperatively. Moreover, intraoperative vital life signs and treatments methods, the incidence of postoperative complications and length of hospital stay were similar between the two anesthesia techniques.Surgical trauma initiates a neuroendocrine response and is accurately indicated by changes in some neuroendocrine mediators, including ACTH, GC, thyroid hormones, GH and PRL. The stress response can be reduced by GA alone or in combination with other anesthesia techniques [CP might compress the pituitary gland and impact its normal function, thereby causing endocrine deficits. Do different anesthetics cause additional injuries in pediatric CP patients who already have endocrine deficits? Although there is no lack of comparative studies of different anesthesia types on the stress response, there are few studies of hormone changes caused by sevoflurane and propofol in pediatric CP patients.It is known that the choice of anesthetic affects the neuroendocrine stress. In our study, propofol inhibited the levels of ACTH, FT3, TT3, FT4 and TT4 more extensively. At the end of the operation, the levels of TT3 and ACTH were still lower in the propofol group.GC and ACTH are major biomarkers of the classical stress endocrine response. GA could reduce the stress response induced by surgery. The changes in GC and ACTH levels in our study were consistent with those in a previous retrospective study [Fewer studies have investigated effects of different anesthetics on thyroid hormone levels. Our results showed that propofol and sevoflurane reduced thyroid hormone levels perioperatively, and the effect of propofol was much stronger. Hypothalamic TSH and other thyroid hormones play several vital roles in human stress [Regarding the antistress effects of GA, we found that propofol and sevoflurane could reduce the levels of PRL and GH 72 h after the operation. However, their influence on GH and PRL levels was similar postoperatively, even at 3 months postoperatively [There is a lack of studies investigating the interruption of different anesthesia techniques on hormone levels in pediatric patients with CP. This is a critical clinical concern because of their hormone deficiencies. Long-term hormone deficiency could lead to retardations in growth and development, an increased risk of cardiovascular disease, and so on [