[Clinical study of arterial ketone body ratio (ACAC/beta-OHCS) during hepatectomy]

The changes in arterial ketone body ratio (acetoacetate/beta-hydroxybutyrate) were investigated in 7 patients undergoing hepatectomy under epidural anesthesia with nitrous oxide and oxygen. The plasma levels of glucose, insulin, glucagon, lactate, pyruvate and non-esterified free fatty acid (NEFA) were measured during the operation. The plasma level of insulin activity increased significantly during surgery. The secretory capability of insulin against glucose load was relatively preserved. Arterial ketone body ratio also increased during the operation. The plasma insulin activity was positively correlated significantly with the arterial ketone body ratio (Y = 0.98 + 0.76X; r = 0.76). Both lactate and pyruvate increased significantly during surgery. No remarkable changes of L/P ratio reflecting the redox state in cytoplasma were found in both groups. Our results suggest that the quantity of glucose load and insulin activity should be considered when arterial ketone body ratio is measured during the operation.