Influence of perioperative stress on central and peripheral oxytocin and arginine‐vasopressin concentrations

Abstract

Perioperative stress provides not only physical, but also psychic and emotional aspects, which may influence the hypothalamic neuropeptide system. Studies investigating the perioperative course of central neuropeptide activity are missing. Therefore, the present study aimed to determine perioperative fluctuations in central and concomitant peripheral concentrations of the hypothalamic neuropeptides oxytocin (OXT) and arginine‐vasopressin (AVP), as well as their impact on perioperative anxiety and depression. Cerebrospinal fluid (CSF), blood and saliva were collected from 12 patients who underwent elective endovascular aortic repair with a routinely inserted spinal catheter. AVP and OXT concentrations were analysed at four timepoints: (i) the evening before the operation; (ii) the operation day immediately before anaesthesia induction; (iii) intraoperatively after the stent was placed; and (iv) on day 1 after the operation. Patients completed the Hospital Anxiety and Depression Scale (HADS) at timepoints 1 and 4. For CSF OXT, the present study showed a significant intraoperative decline, accompanied by a decrease in saliva. OXT blood concentrations before anaesthesia induction were higher than at the evening before the operation. OXT concentrations in CSF and saliva correlated well at timepoints 2‐4. AVP concentrations in CSF, blood and saliva did not show any significant changes perioperatively. However, postoperative AVP blood concentrations showed a significant negative correlation with anxiety and depression scores according to the HADS. This pilot study demonstrates perioperative fluctuations in central OXT concentrations, which are better reflected by saliva than by blood. Further studies are required to determine whether OXT and AVP can predict postoperative post‐traumatic stress disorder.

Isoflurane Rapidly Modifies Synaptic and Cytoskeletal Phosphoproteomes of the Supraoptic Nucleus of the Hypothalamus and the Cortex

“…This might be indicating a role for central MCN projections to other brain regions or dendritic release in inducing early anaesthetic effects. Indeed, anaesthesia itself does seem to affect circulating AVP levels [33][34][35], although increases do occur during intense surgical stimulation [36]. Interestingly, both the CC and SON displayed phosphoproteomic adaptations to GA, suggesting that Fos expression is not a defining marker for cellular change following GA. How are phosphorylation responses to GA influencing neuronal activity or function?…”

Sex-specific issues of central and peripheral arginine-vasopressin concentrations in neurocritical care patients

“…Another issue is the time of sample collection, which is assumed to influence hypothalamic neuropeptide concentrations especially in the central compartment [ 22 ]. However, studies on neurocritical care patients which mainly examined patients with aneurysmal subarachnoid hemorrhage, showed that AVP secretion neither in the blood nor in the CSF follows a diurnal rhythm [ 23 , 24 ]. In our study on a more heterogenous patient collective, samples were obtained only during day shifts, where a steady level of light and noise prevailed at the ward to minimize potential external influences on AVP secretion.…”

Evaluation of salivary vasopressin as an acute stress biomarker in healthy dogs with stress due to noise and environmental challenges

“…According to one study [22], dogs with a history of aggression had lower free AVP but higher total plasma AVP than matched controls. Furthermore, a recent human study done in patients with perioperative anxiety, demonstrated that there is a weak correlation between AVP concentrations in saliva, blood, and cerebrospinal fluid (CSF), which casts some doubt on the role of salivary, or blood, AVP levels as a representation of central AVP activity [43].…”