Postoperative elevated cortisol excretion is not associated with suppression of 6-sulfatoxymelatonin excretion

This study tests the hypothesis that elevated postoperative excretion of cortisol is associated with suppression of the nocturnal excretion of 6‐sulfatoxymelatonin, the chief metabolite of the circadian hormone, melatonin. Postoperative patients demonstrate circadian rhythm disturbances and suppress...

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Bibliographic Details
Published in:Acta anaesthesiologica Scandinavica 2005-01, Vol.49 (1), p.52-57
Main Authors: Derenzo, J., Macknight, B., DiVittore, N. A., Bonafide, C. P., Cronin, A. J.
Format: Article
Language:English
Subjects:
6-SM
Adult
Aged
Anesthesia
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
arthroplasty
Arthroplasty, Replacement, Hip
Arthroplasty, Replacement, Knee
Biological and medical sciences
circadian rhythm
Circadian Rhythm - physiology
cortisol
Female
Humans
Hydrocortisone - urine
Linear Models
Male
Medical sciences
melatonin
Melatonin - analogs & derivatives
Melatonin - urine
Middle Aged
Postoperative Period
Stress, Physiological - urine
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Summary:This study tests the hypothesis that elevated postoperative excretion of cortisol is associated with suppression of the nocturnal excretion of 6‐sulfatoxymelatonin, the chief metabolite of the circadian hormone, melatonin. Postoperative patients demonstrate circadian rhythm disturbances and suppression of nocturnal melatonin plasma concentration. Since the nocturnal surge in melatonin concentration in normal volunteers is time‐locked to the circadian nadir of cortisol concentration, perhaps the attenuation of the nocturnal melatonin surge in postoperative patients results from prolonged elevation in the plasma cortisol concentration. In this observational study performed in 21 patients having unilateral hip or knee arthroplasty, urine was collected every 4 h for the first 48 h after surgery for measurement of urinary 6‐sulfatoxymelatonin (EIA) and free cortisol (RIA) excretion. The total (P 
ISSN:0001-5172
1399-6576
DOI:10.1111/j.1399-6576.2004.00520.x