title: Glucose homeostasis during anesthesia and surgery in infants.
abstract: Baseline, preinduction, postinduction, and postsurgical plasma samples were collected for glucose, insulin, and cortisol in 16 neonates and infants. Glucose infusion rate was maintained constant (mean +/- SD 4.1 +/- 1.2 mg/kg/min) prior to and during surgery; additional fluid losses during surgery were replaced by fluids without dextrose. The weight at the time of surgery was 3,038 +/- 1,397 g. Postnatal age at the time of study ranged from one day to 40 weeks and the duration of surgery was 83 +/- 35 minutes. Plasma glucose values were higher than baseline values soon after induction of anesthesia (88 +/- 11 v 130 +/- 36 mg/dL; P less than .05); postsurgical glucose values were significantly higher than postinduction values (210 +/- 109 mg/dL v 130 +/- 36 mg/dL, P less than .01). Postsurgical plasma glucose had a negative correlation with weight of infants at the time of study (P less than .01; r = .61). Insulin changes were minimal and variable. Cortisol values did not change significantly from baseline values until the end of surgery (11.9 +/- 8.3 v 22.2 +/- 10.6 micrograms/dL; P less than .05). Hyperglycemia (greater than 150 mg/dL) was noted in 10/16 infants. This study indicates that glucose levels should be monitored and that additional fluid losses should be replaced by fluids without dextrose in neonates undergoing surgical procedures since hyperglycemia is a common occurrence.
mesh_terms: D000758:Anesthesia; D001786:Blood Glucose / Q000378:metabolism*; D001835:Body Weight; D002675:Child, Preschool; D006706:Homeostasis; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006943:Hyperglycemia / Q000209:etiology; D007223:Infant; D007231:Infant, Newborn; D007328:Insulin / Q000097:blood; D013514:Surgical Procedures, Operative
chemical_list: D001786:Blood Glucose; D007328:Insulin; D006854:Hydrocortisone