Endocrine and metabolic response to surgery and its management

The physiological and biochemical events which occur in the child undergoing surgical interventions are multifaceted, inter-relational and complex. Many serve to facilitate the recovery and survival of the child undergoing a surgical stress. However, when unchecked, some can result in patient morbidity and increased mortality. The advent of minimally-invasive surgical practice has further added to the interest that such techniques may blunt the potential adverse response in the child to traditional surgical stresses. Much scientific endeavor has been spent in investigating these, as yet not fully understood, responses in the human child. This chapter explores the knowledge available concerning the child's responses to the trauma of surgery and attempts to provide practical insight into the management of these physiological challenges for the clinician.