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Glucose intolerance during prolonged sevoflurane anaesthesia

H Iwasaka1, K Itoh, H Miyakawa

  • 1Department of Anaesthesiology, Oita Medical University, Japan.

Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|October 1, 1996
PubMed
Summary

Prolonged sevoflurane anesthesia impairs insulin sensitivity, leading to reduced glucose clearance and diminished insulin response during surgery. This study highlights anesthesia-induced glucose intolerance in surgical patients.

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Area of Science:

  • Anesthesiology
  • Metabolic Medicine
  • Surgical Research

Background:

  • Sevoflurane is a common inhalation anesthetic used in prolonged surgeries.
  • Understanding its impact on glucose metabolism and insulin sensitivity is crucial for patient care.

Purpose of the Study:

  • To investigate the effects of prolonged sevoflurane anesthesia on insulin sensitivity.
  • To assess glucose tolerance and insulin response during and after extended surgical procedures.

Main Methods:

  • Two successive intravenous glucose tolerance tests (IVGTT) were performed on eight surgical patients.
  • Blood glucose and plasma insulin levels were measured at timed intervals during each IVGTT.
  • The first IVGTT was conducted 35 minutes after surgery initiation, and the second six hours later.

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Main Results:

  • Glucose disappearance rate (k-value) was lower than normal in both IVGTTs, indicating impaired glucose tolerance.
  • The maximum insulin response and total insulin output were significantly reduced in the second IVGTT compared to the first.
  • These findings suggest a progressive decline in insulin secretion and action during prolonged anesthesia.

Conclusions:

  • Prolonged sevoflurane anesthesia and surgery exacerbate glucose intolerance.
  • Diminished insulin output in response to elevated blood glucose contributes to impaired glucose metabolism.
  • Anesthesia management should consider potential impacts on glycemic control.