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Risk factors for hyperketonemia in cleft lip and palate infants during general anesthesia

Yoshinari Morimoto1, Mitsutaka Sugimura, Hiroshi Hanamoto

  • 1Department of Dental Anesthesiology, Osaka University Graduate School of Dentistry, Osaka, Japan. ysn-mori@dent.osaka-u.ac.jp

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|July 26, 2011
PubMed

Insights

Infants undergoing anesthesia are at risk for hyperketonemia. Older infants and afternoon surgeries increase this risk, even with glucose administration. Careful patient selection and timing are key for preventing high ketone levels.

Area of Science:

  • Pediatric Anesthesiology
  • Metabolic Disorders
  • Infant Health

Background:

  • Hyperketonemia in infants can result from lipid catabolism during anesthesia.
  • Glucose administration is used to prevent hyperketonemia, but risk factors require further investigation.

Purpose of the Study:

  • To identify risk factors for hyperketonemia in infants receiving glucose during general anesthesia.
  • Investigate the impact of patient age, anesthesia start time, and preoperative fluid intake.

Main Methods:

  • 147 healthy infants (2-24 months) were studied, divided into cleft lip and cleft palate groups.
  • Preoperative fluid intake and intraoperative glucose infusion (195 mg/kg/hour) were standardized.
  • Blood ketone bodies (β-hydroxybutyrate) and glucose levels were measured at anesthesia induction and 2 hours post-induction.

Main Results:

  • Abnormally high ketone body concentrations (≥ 1.0 mmol/L) were found in 34 infants.
  • Age (P = .001), specifically the cleft palate group (P < .001), and afternoon anesthesia start times (P = .003) were significantly associated with hyperketonemia.
  • No significant difference in preoperative liquid intake was observed between groups.

Conclusions:

  • Age group (cleft palate) and afternoon anesthesia start times are significant risk factors for hyperketonemia in infants.
  • These findings aid in optimizing anesthetic management to prevent hyperketonemia in pediatric patients.
Abstract

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