Some Effects of Anaesthesia and Surgery on Carbohydrate and Fat Metabolism

Allison, S.P.; Tomlin, P. J.; Chamberlain, Michael J.

doi:10.1093/bja/41.7.588

Cited by 167 publications

(68 citation statements)

References 7 publications

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“…The emotional stress of being brought to the operating theatre and the stress of surgery seem to be more important than anesthesia in causing a rise in blood sugar and plasma FFA [28]. However, we suggest the anesthetic management in this study, particularly in nutrition, could control the metabolic changes induced by surgical stress.…”

Section: Discussionmentioning

confidence: 70%

Effect of Glucose Administration on the Metabolism during Surgery

Kitamura¹,

Hirokawa

Sako³

et al. 2016

J Diabetes Metab

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Section: Discussionmentioning

confidence: 70%

Effect of Glucose Administration on the Metabolism during Surgery

Kitamura¹,

Hirokawa

Sako³

et al. 2016

J Diabetes Metab

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“…Allison et ul. 10 observed that halothane was unable to prevent the rise in blood sugar and FFA, nor the suppression of insulin response to glucose associated with surgery.…”

Section: Discussionmentioning

confidence: 95%

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

1972

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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.

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“…The invariant features of the metabolic stress response include release of the catabolic hormones epinephrine, norepinephrine, cortisol, glucagons, and growth hormone [11][12][13][14][15][16] and inhibition of insulin secretion and action. [17][18][19] Anti-Insulin Effects of Surgical Stress In addition to insulin resistance induced by circulating stress hormones, surgical stress has a deleterious effect on pancreatic ␤-cell function.…”

Section: From Research To Practice / Acute Care Of Patients With Diabmentioning

confidence: 99%

“…[11][12][13][14][15][16] The catecholamines (norepinephrine is augmented mostly during surgery and epinephrine postoperatively) stimulate gluconeogenesis and glycogenolysis, inhibit glucose utilization by peripheral tissues, and inhibit insulin secretion. 20 Activation of phosphoproteins by cAMP-dependent protein kinases accounts for the stimulatory effects of catecholamines on liver and muscle glycogen breakdown, whereas phosphorylation of glycogen synthase accounts for the decreased glycogen synthesis.…”

Section: Direct Catabolic Effects Of Stress Hormonesmentioning

confidence: 99%

Management of Diabetes Mellitus in Surgical Patients

Dagogo‐Jack¹,

Alberti²

2002

Diabetes Spectrum

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In Brief Diabetes is associated with increased requirement for surgical procedures and increased postoperative morbidity and mortality. The stress response to surgery and the resultant hyperglycemia, osmotic diuresis, and hypoinsulinemia can lead to perioperative ketoacidosis or hyperosmolar syndrome. Hyperglycemia impairs leukocyte function and wound healing. The management goal is to optimize metabolic control through close monitoring, adequate fluid and caloric repletion, and judicious use of insulin.

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Some Effects of Anaesthesia and Surgery on Carbohydrate and Fat Metabolism

Cited by 167 publications

References 7 publications

Effect of Glucose Administration on the Metabolism during Surgery

Effect of Glucose Administration on the Metabolism during Surgery

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

Management of Diabetes Mellitus in Surgical Patients

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