[The effect of calories of preoperative oral intake on the glucose metabolic response in children].
We performed prospective study to determine whether the increase of calories with preoperative oral intake will prevent ketosis due to preoperative starvation in children receiving afternoon surgery. Twenty five children (aged 3 to 9 years) for elective minor surgery under general anesthesia with sevoflurane and nitrous oxide were divided into morning surgery group and afternoon surgery group, and the latter was divided into 2 groups according to calories contained in the clear fluid. The calorie of the clear fluid in the afternoon group P was 0.24 kcal.ml-1, and that in the afternoon group A was 0.48 kcal.ml-1. The calorie of the clear fluid in the morning group was 0.48 kcal. ml-1. The levels of blood glucose, blood ketone body, plasma free fatty acids (NEFA), insulin, glucagon and cortisol were measured before and during intravenous infusion in three groups. The urinary catecholamine excretion was measured in the urine collected from 18:00 on the day before operation day until the start of anesthesia. There were no significant differences in the levels of blood glucose, NEFA, insulin, glucagon, cortisol and urinary catecholamine excretion. But the level of blood ketone body only in the afternoon group P was significantly higher than that in the morning group. But the levels of NEFA before infusion were higher than average in 40-60 percent of patients of each group. These data suggest that the increasing preoperative calories with oral intake will prevent ketosis due to preoperative starvation in the afternoon group as well as in the morning group. But the short duration of starvation only can not prevent lipolysis completely.
Niiya
S
S
Department of Anesthesiology, Nagasaki Rosai Hospital, Sasebo.
Nakamura
T
T
Hara
T
T
Miyako
M
M
Fukusaki
M
M
D001786:Blood Glucose / Q000378:metabolism*; D002675:Child, Preschool; D002149:Energy Intake; D005260:Female; D006801:Humans; D007662:Ketosis / Q000209:etiology / Q000517:prevention & control; D008297:Male; D011300:Preoperative Care; D011446:Prospective Studies; D013217:Starvation / Q000150:complications; D013997:Time Factors
D001786:Blood Glucose