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Anesthesia with sevoflurane or isoflurane induces severe hypoglycemia in neonatal mice
Qian Yu1,2, Jian Li1,3, Chun-Ling Dai1
1Department of Neurochemistry, Inge Grundke-Iqbal Research Floor, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York, United States of America.
Insights
Sevoflurane and isoflurane anesthesia cause severe hypoglycemia in neonatal mice, but hyperglycemia in adults. This finding highlights the need for careful blood glucose monitoring in infants during inhalational anesthesia.
Area of Science:
- Anesthesiology
- Pediatric Metabolism
- Neonatal Physiology
Background:
- General anesthetics like sevoflurane and isoflurane are widely used in pediatric patients, including infants.
- The metabolic effects, particularly on blood glucose, of these anesthetics in children are not fully understood.
Purpose of the Study:
- To investigate the impact of sevoflurane, isoflurane, propofol, and avertin anesthesia on blood glucose levels in neonatal and adult mice.
- To determine if inhalational anesthetics specifically affect glucose metabolism differently across age groups.
Main Methods:
- Neonatal (7-8 days) and adult (2-3 months) mice were anesthetized for up to 6 hours using inhalational anesthetics (sevoflurane, isoflurane) or injectable anesthetics (propofol, avertin).
- Blood glucose levels were monitored throughout the anesthesia period.
- Survival rates were assessed in relation to anesthesia type and pre-anesthetic treatment.
Main Results:
- Sevoflurane and isoflurane induced severe hypoglycemia in neonatal mice, while propofol and avertin did not.
- In contrast, inhalational anesthesia led to hyperglycemia in adult mice.
- Hypoglycemia was a significant factor in the mortality of neonatal mice.
Conclusions:
- Inhalational anesthetics (sevoflurane, isoflurane) differentially affect glucose metabolism in neonatal versus adult mice.
- Neonatal mice are at high risk for severe hypoglycemia during sevoflurane or isoflurane anesthesia.
- Clinical monitoring of blood glucose levels in infants undergoing inhalational anesthesia is recommended to prevent adverse outcomes.
Abstract:
Sevoflurane and isoflurane are among the most commonly used general anesthetics for children including infants, but their impact on metabolism, especially on blood glucose level, in children is not well understood. We investigated the impacts of anesthesia of neonatal (7-8 days old) and adult (2-3 months old) mice with the inhalational anesthetics 2.5% sevoflurane or 1.5% isoflurane, or the injectable anesthetics propofol (150 mg/kg) or avertin (375 mg/kg), for up to 6 hours. We found that sevoflurane and isoflurane induced severe hypoglycemia in neonatal mice and that this phenomenon was specific to the inhalational anesthetics because the injectable anesthetics propofol and avertin did not induce hypoglycemia. Surprisingly, the inhalational anesthesia induced hyperglycemia instead in adult mice. We also demonstrated that the inhalational anesthesia-induced hypoglycemia was a major cause of death for the neonatal mice receiving intranasal administration of saline prior to anesthesia. These studies revealed severe hypoglycemia in neonatal mice during anesthesia with sevoflurane or isoflurane. If this phenomenon also occurs in human, our findings would warrant closely monitoring blood glucose level and maintaining it in the normal range in infants receiving inhalational anesthesia.
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