The changes in arterial keton bodies during upper abdominal surgery

Area of Science:

• Anesthesiology
• Endocrinology
• Metabolic Research

Background:

• The arterial ketone body ratio (AKBR), defined as acetoacetate/Beta-hydroxybutyrate, is a metabolic marker.
• Understanding AKBR dynamics during surgery is crucial for metabolic management.
• Hormonal influences on AKBR, particularly insulin, require further investigation.

Purpose of the Study:

• To investigate the relationship between the arterial ketone body ratio (AKBR) and plasma hormone activities.
• To compare AKBR and hormonal responses between general anesthesia with enflurane and general anesthesia with epidural anesthesia during partial gastrectomy.
• To determine the impact of insulin activity on AKBR during surgical procedures.

Main Methods:

• A study involving two groups of patients undergoing partial gastrectomy under general anesthesia.
• Group G received enflurane anesthesia, while Group E received enflurane plus epidural anesthesia with continuous glucose loading.
• Measurements included arterial ketone body ratio (AKBR) and plasma hormone activities, with statistical analysis of correlations.

Main Results:

• The arterial ketone body ratio (AKBR) significantly increased in both anesthetic groups during the operation.
• Plasma insulin activity showed a significant positive correlation with AKBR.
• A significant negative correlation was observed between plasma insulin activity and Beta-hydroxybutyrate levels.

Conclusions:

• Plasma insulin activity significantly affects the arterial ketone body ratio (AKBR).
• The AKBR should be interpreted in the context of concurrent plasma hormone activity, especially insulin.
• No significant difference in AKBR was found between the general anesthesia and general anesthesia plus epidural groups.