Introduction: Surgical intervention and anesthesia procedure lead to a series of hormonal changes in the organism, which is mainly attributed to catecholamine response to stress. Surgical intervention is resulting in significant changes in neuroendocrine regulation, metabolism and physiological functions, as part of the overall response to stress. Research aim: The aim of this study was to determine and evaluate the levels of hormones in patients undergoing transvesical prostatectomy under general or local anesthesia. Material and methods: The study included a total of 100 patients from the Clinic of Urology, Clinical Center of Sarajevo who underwent surgery by technique of transvesical prostatectomy (BPH) in which the indicators were set:: a) repeated urinary retention; b) calculosis and diverticulosis of the urinary bladder; c) urinary infection, d) repeated massive hamaturia and e) the distal obstruction that can lead to uremia. Results: General anesthesia may limit the perception of stimuli from injury, but does not eliminate the full response to noxious stimuli, even with deep anesthesia. All intravenous agents andvolatile anesthetics in normal doses have little effect on the endocrine and physiological functions. Neural blockade induced by regional anesthesia or local anesthetics have a direct impact on endocrine and metabolic response. Regional anesthesia with the present consciousness, but with sympathetic blockade caused a greater suppression of hormonal responses than the general balanced anesthesia. In our research we obtained: a) a significant increase in prolactin intraoperatively, for respondents under general anesthesia; b) a significant increase in TSH values intraoperatively for respondents under general anesthesia; c) a significant drop in T4 intraoperatively in patients with regional anesthetic technique; d) a significant increase in cortisol values 24 hours postoperatively in patients with regional anesthetic technique.

INTRODUCTION Hypovolemia and pain are direct stimulators of hormonal response to trauma. Thus, neuroendocrine, metabolic and inflammatory aspects of the injury are part of an overall "stress response". In particular, it manifests in patients undergoing surgical intervention. These reactions can occur with trauma, burns, severe infections and physical exertion. Metabolic and neuroendocrine response to surgical intervention depends on several factors, such as severity and duration of the surgical trauma, patient's age, type of anesthesia and surgical techniques. GOAL The aim of this study was to determine and evaluate levels of hormones in patients undergoing transvesical prostatectomy under general or local anesthesia: ACTH, PRL, TSH, T3, T4, cortisol, and to determine the influence of consciousness (in local-regional anesthesia) in relation to the unconscious state in the general balanced anesthesia on hormonal response measured values above mentioned levels of hormones. Determined the level of hormone values during three time periods: before anesthesia, during surgery in enucleation of prostate glandular tissue and 24 hours after surgery. PATIENTS AND METHODS The study included a total of 100 patients from the Clinic of Urology, Clinical Center of Sarajevo who underwent surgery by technique oftransvesical prostatectomy. According to the criteria defined the subjects were divided into two test groups: Group I (n = 50)--patients underwent surgery under general anesthesia, Group II (n = 50)--patients underwent surgery in local-regional anesthesia. The first blood sample was taken at screening purposes just before the introduction of general anesthesia or loco regional anesthesia. The second sample was taken during surgery during enucleation of prostate gland tissue. A third blood sample was taken 24 hours after surgery. RESULTS Increased levels of ACTH intraoperative in both anesthesia techniques applied, with a slightly larger increase in the value of the respondents with technique of general anesthesia. The values of ACTH after 24 hours showed a return to preoperative values in case of both techniques of anesthesia. Increased levels of PRL intraoperative in both anesthesia techniques applied, with larger peak values registered in patients under technique of general anesthesia (3554microIJ/L). High levels of PRL are maintained and postoperatively after 24 hours with both techniques applied anesthesia. Increased intraoperative levels of TSH in both anesthetic techniques, with higher maximum values in patients with technique of general anesthesia (7.20 mU/L). The values of TSH postoperatively after 24 hours showed a return to baseline in case of both applied technique of anesthesia. Low intraoperative values of T3 in both anesthetic techniques. Lower values of T3 are still continuing after 24 hours postoperatively in both applied techniques of anesthesia. The values of T4 hormone in subjects under general anesthesia did not show major deviations intraoperatively or postoperatively. CONCLUSIONS Regional anesthesia with the present consciousness, but with sympathetic blockade caused a greater suppression of hormonal responses, than the general balanced anesthesia.