ArticleJournal of Indian Association of Pediatric Surgeons
Salivary Cortisol as a Surrogate Marker of Stress Response in Children Undergoing Laparoscopic Surgery with Low-pressure versus Standard-pressure Pneumoperitoneum.
Article in Journal of Indian Association of Pediatric Surgeons. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
Purpose: Salivary cortisol is a validated, non-invasive biomarker of hypothalamic-pituitary-adrenal axis activity and surgical stress. Evidence on perioperative cortisol kinetics in children undergoing laparoscopic surgery is limited. This study evaluated temporal salivary cortisol trends and compared stress responses between low- and standard-pressure pneumoperitoneum (PP) in children undergoing laparoscopic surgery. Methods: In this prospective randomized trial, 101 children scheduled for laparoscopic surgery were allocated to low-pressure PP (6-8 mmHg) or standard-pressure PP (9-11 mmHg) using block randomization. Salivary cortisol was measured preoperatively and at 6, 12, 24, 48, and 72 h postoperatively using enzyme-linked immunosorbent assay. Hemodynamic and respiratory parameters, pain scores, time to resume feeding, and hospital stay were recorded and analyzed. Results: Ninety-three children completed the study (low-pressure: Conclusion: Salivary cortisol is a reliable, noninvasive marker of perioperative stress in children undergoing laparoscopic surgery with a consistent postoperative trajectory. Within 6-11 mmHg, PP pressure did not influence stress response, intraoperative physiology, or short-term recovery.
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