Hormone levels have been established in the normal human volunteer as well as in a variety of disease states. However, there is little available information that delineates the normal hormonal response to surgical stress. The physiologic response to surgical stress is particularly relevant to the patient receiving chronic exogenous glucocorticoids who either electively or emergently undergoes a surgical procedure. These patients are at risk for the development of irreversible shock in the perioperative period if their glucocorticoids are not replaced. However, indiscriminate or excessive steroid coverage may needlessly subject these patients to the deletrious of high dose steroids. The judicious use of replacement steroids in this patient population is supported by recent data in humans which suggest that they may require little or no supplementation during surgical stress. A clear understanding of the physiologic hormonal response to surgical stress is essential in order to devise rational hormone replacement schedules for patients with diseased endocrine organs who subsequently undergo surgical procedures. The purpose of this study is to define the normal range of peptide, steroid, and glycoprotein hormone responses in patients undergoing surgical stress.
