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Low-dose insulin infusion and substrate mobilization during surgery
British Journal of Anaesthesia
|October 1, 1983
Summary
Intravenous insulin infusion during gynecological surgery significantly altered metabolic and endocrine responses. It decreased key metabolites like glucose and fatty acids, while increasing lactate and growth hormone, impacting patient temperature.
Area of Science:
- Endocrinology
- Metabolic Medicine
- Surgical Physiology
Background:
- Surgical stress triggers significant metabolic and endocrine changes.
- Insulin plays a crucial role in regulating glucose and lipid metabolism.
Purpose of the Study:
- To investigate the impact of intravenous insulin infusion on metabolic and endocrine responses during gynecological surgery.
- To understand how insulin affects circulating metabolites and hormonal responses in surgical patients.
Main Methods:
- Patients received intravenous insulin infusion at specific rates (70 mu.kg-1h-1 for 60 min, then 35 mu.kg-1h-1).
- Metabolic markers (glucose, non-esterified fatty acids, beta-hydroxybutyrate, lactate) and endocrine markers (cortisol, growth hormone) were measured.
- Hemodynamic parameters (heart rate, arterial pressure) and body temperature were monitored.
Main Results:
- Insulin infusion markedly decreased circulating glucose, non-esterified fatty acids, and beta-hydroxybutyrate.
- Blood lactate levels increased, and growth hormone response to surgery was elevated.
- Plasma cortisol response was unaffected, while aural temperature decreased more significantly.
Conclusions:
- Insulin infusion significantly alters metabolic profiles during gynecological surgery.
- The study highlights the role of insulin in mediating metabolic changes, particularly concerning circulating metabolites.
- Insulin's effects on hormonal responses and thermoregulation warrant further investigation in surgical contexts.