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Decreased glucose utilization during prolonged anaesthesia and surgery.
1Department of Anaesthesiology, University of Hirosaki School of Medicine, Japan.
Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|September 1, 1990
Summary
Prolonged anesthesia and surgery impair glucose metabolism, significantly reducing glucose utilization. This occurs despite stable levels of key catabolic hormones, indicating increased insulin resistance.
Area of Science:
- Metabolic Medicine
- Surgical Physiology
- Endocrinology
Background:
- Prolonged anesthesia and surgery can significantly impact a patient's physiological state.
- Understanding the effects on glucose metabolism is crucial for patient management.
Purpose of the Study:
- To investigate the influence of prolonged anesthesia and surgery on glucose metabolism.
- To assess changes in catabolic hormone levels during extended surgical procedures.
Main Methods:
- Utilized the euglycaemic insulin clamp technique to measure glucose metabolism.
- Compared a group undergoing prolonged surgery (PA group) with a control group (short surgery).
- Monitored plasma concentrations of catabolic hormones and free fatty acids.
Main Results:
- Glucose utilization was significantly lower in the prolonged anesthesia group (4.03 mg.kg-1.hr-1) compared to the control group (7.59 mg.kg-1.hr-1).
- Plasma-free fatty acid levels were significantly elevated in the PA group before the clamp procedure.
- No significant differences in plasma catecholamine and glucagon levels were observed between groups.
Conclusions:
- Prolonged anesthesia and surgery lead to increased tissue resistance to insulin.
- Elevated free fatty acid levels suggest altered lipid metabolism during extended surgical stress.
- Metabolic disturbances occur independently of significant changes in major catabolic hormone levels.