Effects of intravenously administered solutions on electrolytes and energy substrates during surgery

Moffitt, Emerson A.; Schnelle, Norbert; Rodríguez, R.; Lee, Raymond A.; Judd, Edward S.

doi:10.1007/bf03005733

Canad. Anaesth. Soc. J.

1974

DOI: 10.1007/bf03005733

|View full text |Cite

Effects of intravenously administered solutions on electrolytes and energy substrates during surgery

Emerson A. Moffitt

Norbert Schnelle

R. Rodríguez

et al.

Abstract: TrmnE is MUCH CONTROVERSY about which is the most beneficial type of solution for intravenous infusion during general anaesthesia and major operation, and what its volume should be. Probably the most widely used is lactated Ringer's solut/on 1 which often is given in large anaounts to maintain electrolyte balance and both intravascular and extracellular fluid volumes. A major disadvantage of this solution is that the exogenous lactate does not supply energy as readily as glucose. Without exogenous glucose, the… Show more

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...

Citation Types

Supporting

Mentioning

Contrasting

Year Published

1975

1982

Publication Types

Select...

Article3

Relationship

Self Cite0

Independent3

Authors

Journals

Cited by 3 publications

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Blood substitutes

Moffitt

1975

Canad. Anaesth. Soc. J.

View full text Add to dashboard Cite

SUBSTITUTES for whole blood include fractions of blood, such as plasma, serum albumin, and true substitutes such as the plasma volume expanders and intravenous crystalloid solutions. BACKGROUNDCzerny reported in 1894 ~ on the intravenous injection of colloids in animals, after giving gum arabic or gelatin to dogs, cats, and rabbits. He found an increase of blood viscosity after giving gum arabic and decreased RBC count after colloid injection. Hogan in 1915 first used colloidal gelatin intravenously with improvement in blood pressure of patients in shock. '-' In 1918 Bayliss treated wound shock for the first time with gum acacia? Many of the patients improved; those who did not also did not respond to transfusion of blood. Gronwall and Ingelman reported their work with dextrin in 1945 and advocated it as appropriate for treatment of shock? It has been in clinical use ever since. ESSENTIALS OF AN ACCEPTABLE PLAS~,IA SUBSTITUTEMajor considerations ~ are that it must maintain a satisfactory colloidal osmotic pressure, be capable of manufacture at a constant composition and reasonable price, be stable in storage and on exposure to wide variations in temperature, be easily sterilized by autoclaving and have a suitable viscosity for intravenous administration. It must be pyrogen flee, be excreted or metabolized without damage to tissues and not be antigenic. Another factor is that it should remain in the vascular compartment for 12 to 24 hours. ' It should not produce haemolysis, red blood cell agglntination, or increased sedimentation rate. It should not alter other functions of the blood, or impair haemostasis. Advantages of Plasma SubstitutesSubstances capable of expanding plasma volume are of critical importance in dealing with disasters involving many casualties and with less emergent needs in remote areas where blood is not availabled Non-biological substitutes for blood can be manufactured in large quantities and stored for long periods of time. In many cases of shock there is need for increase of circulating volume, while sufficient red cells are still present for adequate carriage of oxygen. The risks of blood transfusion are the advantages of plasma substitutes: avoidance of bacterial or viral infection, transfusion reactions and Rh sensitization. With plasma substitutes, one

show abstract

Blood substitutes

Moffitt

1975

Canad. Anaesth. Soc. J.

View full text Add to dashboard Cite

show abstract

Patterns of total and ionized calcium and other electrolytes in plasma during and after general surgery

Rodríguez

Jones

Adson

et al. 1976

Canad. Anaesth. Soc. J.

View full text Add to dashboard Cite

CnLcitr~ plays a dominant role in many biochemical processes that are critical to body homeostasis. 1 Blood clotting and muscle contraction are two mechanisms in which ionic calcium is essential. In the myofibril, calcium ions entering the cell on depolarization, and those freed from an intracellular bound form act to cause sarcomere shortening? The other electrolytes, sodium, potassium, magnesium, and inorganic phosphate are also necessary in proper concentrations for balanced biological systems3How much of what kinds of intravenous solution to give during operation is an everyday consideration for anaesthetists. Does giving dextrose in water alter the pattern of plasma electrolytes, particularly calcium, compared to giving Ringer's lactate solution? Seeking an answer, we studied 13 patients during anaesthesia for abdominal operations who received one or other of these two intravenous solutions. PATIENTS STUDIEDThe six females and seven males averaged 55 years of age (range 39--76), and 77 kg weight (range 50-92). All were intra-abdominal operations, except for one herniorraphy. Their A.S.A. physical status categories were Class 1-8 and Class II-5.All patients were induced with thiopentone, given succinylcholine for intubation and maintained with nitrous oxide and tubocurare. In addition, halothane was given to all but two patients, who had Innovar| Nine patients, with a mean anaesthetic time of 123 minutes, received a mean volume of dextrose/water of 816 ml during operation and for one hour in the recovery room. The group who received a mean volume of 707 ml of 5 per cent dextrose/Ringer's lactate, averaged 116 minutes of anaesthesia. The intended flow rate was 250 ml per hour over the three hours. No blood was transfused. STuDY PRoTOCOLSerial samples of venous blood were drawn in heparinized syringes, without tourniquet, before induction, at mid-operation and end-operation and one hour afterwards. Samples were iced and biochemical determinations began within 15 minutes. Blood-gas analyses were done by electrodes ( Instrumentation Laboratory, Inc.) without correction for body temperature. Concentrations of several con-*From the

show abstract

Maltose as an energy substrate during surgery: Comparison of maltose with glucose

Aono

Kawachino

Satoh

1982

Can. Anaesth. Soc. J.

View full text Add to dashboard Cite

To evaluate the usefulness of maltose as an energy substrate to be administered during surgery, five per cent maltose in lactated Ringer's solution and five per cent glucose in lactated Ringer's solution were administered to 10 cases each, at a rate of 5 ml.kg -~ hour (0.25 g'kg -t hour as sugar) for two hours from the start of oral surgery, and their metabolic effects were compared.The maltose group showed a smaller increase in blood sugar level than the glucose group immediately after the completion of infusion. The mean plasma concentration of maltose reached a maximum of 121.6 mg/dl, and it remained at 12.3 mg/dl at four hours, indicating that the retention time of maltose in blood was longer than that of glucose. The mean recovery of sugar from four-hour urine samples was 3.26 per cent in the maltose group and 0.06 per cent in the glucose group respectively, showing greater urinary excretion by the maltose group.Plasma insulin was elevated less after maltose than after glucose infusion. The elevation following maltose infusion was considered not to be due to the administration of maltose per se, but to glucose produced from the maltose in the body.The anti-ketogenie effect of maltose was comparable to and tended to last longer than that of glucose.From overall assessment it was concluded that maltose exerts essentially the same metabolic effects as glucose when used under these conditions. KEY WORDS: METABOLISM, energy substrate, maltose, glucose.THE PATIENT is often in a starved state when exposed to the stress caused by surgical operations or other therapy. The stress usually accelerates catabolic responses in the body. However, in such a state there is little sugar in the body usable as an energy source (mainly glycogen) and hence, once it is consumed, muscle protein begins to be converted to glucose by gluconeogenesis and fat tissues are converted to free fatty acids. As a consequence, these are used as a main energy source. The use of protein and fat wastes muscle tissue and induces increases in ketone body and free fatty acid concentrations. To prevent these phenomena, it is necessary to supply sugar as an energy source. Moffitt, etal. 1 reported that glucose given during abdominal surgery increased the metabolism of glucose and decreased the utilization of fat. 23 On the other hand, Young and Weser, et al. 9 demonstrated that intravenous maltose is well Kazuya Aono, M.D., Professor; Nobuko Kawachino, B.S., Kunihiko Satoh, D.D.S., Assistants; Department of Anesthesiology, Fukuoka Dental College, Fukuoka, 814-01 Japan.Can. Anaesth. Soc. J., vol. 29, no. 3, May 1982 utilized in humans. Since then, maltose has been widely used in Japan. Subsequent studies have shown that maltose does not markedly increase blood sugar level and is less insulin-dependent than glucose. A 10 per cent solution of maltose has about the same osmotic pressure as that of plasma, half of that of glucose in the same concentration, which implies that at the same osmotic pressure maltose supplies twice as many calories...

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

customersupport@researchsolutions.com

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Effects of intravenously administered solutions on electrolytes and energy substrates during surgery

Cited by 3 publications

References 3 publications

Blood substitutes

Blood substitutes

Patterns of total and ionized calcium and other electrolytes in plasma during and after general surgery

Maltose as an energy substrate during surgery: Comparison of maltose with glucose

Contact Info

Product

Resources

About