Effects of enflurane (Ethrane) anaesthesia and surgery on carbohydrate and fat metabolism in man

Abstract

Enflurane (Ethrane) is a newly synthesised halogenated ether, which has similar characteristics to halothane 1-3. A few papers have reported the effect of this agent on blood glucose levelsl-3 but no study has been made on the effects of plasma-growth hormone and insulin levels. The present study was undertaken on 15 patients to investigate the influence of enflurane alone on carbohydrate and fat metabolism by determining plasma human growth hormone (HGH), insulin, blood glucose and free fatty acids (FFA), and to compare the effects when an operation is superimposed upon anaesthesia.Human growth hormone of the anterior pituitary gland is known to be related not only to growth but also to the metabolism of glucose, fat and protein. Large rises in plasma HGH concentration during anaesthesia and surgery have recently been reported4-6. MATERIAL AND METHODFifteen patients, ranging in age from 19 to 63 years, were the subjects of the study. All underwent elective operations, and none had hepatic, renal, or endocrine disease, nor a history of steroid therapy. The average operating time was 2 hours and 22 minutes, and the mean anaesthetic time was 3 hours and 24 minutes. They did not receive food or water for at least 10 hours before induction of anaesthesia.Each patient was premedicated with pentobarbitone lOOrng orally 1+ hours, and atropine 0.5mg and pethidine 35mg intramuscularly I hour before the induction of anaesthesia. Enflurane was administered with inspired concentrations of 1 . 5 4 0 % delivered from a Fluotec Mark I1 vaporizer in nitrous oxide (2 litres/min) and oxygen (2 litres/min). Suxamethonium 4Omg was then administered and the patient was intubated.Anaesthesia was maintained with enflurane (1.5 to 3.5 %), nitrous oxide (2 litres/min) and oxygen (2 litres/min). Tubocurarine 15 to 24mg was given in divided doses during intra-abdominal operations.

Effects of Enflurane on Haemodynamics and Oxygen Consumption in the Dog with Special Reference‐ to the Liver and Preportal Tissues

“…Other tissues may have contributed to the decrease in VOzT, Unlike many other volatile anaesthetics, enflurane does not seem to affect blood glucose and FFA levels to any significant extent (MAKELAINEN 1974). Although OYAMA et al (1972) noted a small decrease in FFA levels in man following enflurane anaesthesia, there is hardly any reason to believe that substrate availability would limit To, , during enflurane anaesthesia. The postulated reduction of sympathetic activity (MILLAR et al 1970, SKOVSTED & PRICE 1972 and sympathetic transmission (GOTHERT & WENDT 1977b) seem to be more likely reasons for a decrease in fio2T.…”

Clinical investigations concerning the use of Ethrane for Cesarean section

“…Once the pharmacological and general clinicalanesthetic properties of the inhalation anesthetic, Ethrane, had been extensively documented. [1,3,8,9,11,12,13,15,16,17,19,22,24,25,26,27] it became necessary to investigate the adequacy or unsuitability of the drug for obstetrical procedures. In this connection it should be noted that chemically Ethrane is similar to Methoxyflurane, while pharmacologically it resembles Halothane moreclosely [11].…”

Συμβολη Εις Την Διερευνησιν Της Επιδρασεως Ενος Νεου Πτητικου Αναισθητικου Του Ενφλουρανιου Η Αιθρανιου Επι Της Ηπατικης Λειτουργιας

“…Την αυτήν έπί τοΰ σακχάρου τοΰ αίματος έπίδρασιν τοΰ αίθρανίου παρετήρησαν καί έτεροι έρευνηταί 51 76 2Ι8 . "Οσον άφορα την Ινσουλίνη ν καί τά λιπαρά οξέα τοΰ πλάσματος ό Oyama 190 είς σχετικήν μελέτην αναφέρει ότι ή μέν Ινσουλίνη παρέμεινεν σταθερά κατά την διάρκειαν της αναισθησίας άλλ' ηύξήθη κατά τό πέρας της χειρουργικής επεμβάσεως, τά δέ λιπαρά οξέα τοΰ πλάσματος εμειώθη σαν κατά τήν διάρκειαν τής αναισθησίας άλλ' ηύξήθησαν κατά την φάσιν τής ανανήψεως.…”