Aceto Paola, Lai Carlo, Dello Russo Cinzia, Perilli Valter, Navarra Pierluigi and Sollazzi Liliana
The stress response to surgery includes a number of hormonal changes initiated by neuronal activation of the Hypothalamo-Pituitary-Adrenal (HPA) axis. Surgery is one of the most potent activators of ACTH and cortisol secretion, and increased plasma concentrations of both hormones can be measured few minutes after the start of surgery. A variable inhibition of ACTH-stimulated production of cortisol by anesthetic drugs has been demonstrated in clinical studies. Endocrine response to stress also includes a release of pituitary hormone prolactin which is poorly affected by anesthesia. These two hormones seem to mostly contribute to memory consolidation processes during anesthesia. This review summarizes the main aspects of interaction between stress response to surgery and cognition during general anesthesia.