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Epidural blockade improves substrate utilization after surgery.

T Schricker1, L Wykes, F Carli

  • 1Department of Anesthesia, McGill University, Montreal, Quebec, Canada.

American Journal of Physiology. Endocrinology and Metabolism
|August 19, 2000
PubMed
Summary
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Epidural blockade enhances glucose metabolism and reduces protein breakdown after colorectal surgery. This suggests a shift towards glucose utilization, improving patient recovery post-abdominal surgery.

Area of Science:

  • Metabolic studies
  • Surgical anesthesia

Background:

  • Postoperative recovery after colorectal surgery is often complicated by altered metabolic states.
  • Understanding how to mitigate catabolism and improve substrate utilization is crucial for enhanced patient outcomes.

Purpose of the Study:

  • To investigate the effect of epidural blockade on glucose metabolism and anticatabolic responses following colorectal surgery.
  • To test if epidural anesthesia improves the body's utilization of glucose and reduces protein breakdown post-operatively.

Main Methods:

  • A randomized controlled study involving 16 patients undergoing colorectal surgery.
  • Stable isotope infusion techniques using L-[1-(13)C]leucine and [6, 6-(2)H(2)]glucose to assess metabolic parameters.
  • Comparison of metabolic profiles during fasted and glucose-infused states, with and without epidural blockade.

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Main Results:

  • Epidural blockade did not alter fasted-state metabolism.
  • During glucose infusion, epidural blockade significantly increased glucose clearance (P < 0.05) and respiratory quotient (P < 0.05).
  • A significant decrease in leucine oxidation (P < 0.05) was observed with epidural blockade, correlating inversely with glucose clearance.

Conclusions:

  • Perioperative epidural blockade facilitates whole-body glucose uptake after abdominal surgery.
  • Epidural anesthesia inhibits endogenous protein oxidation, promoting a shift towards glucose-based substrate utilization.
  • These findings suggest epidural blockade plays a beneficial role in optimizing metabolic recovery post-colorectal surgery.