title: Integrated analysis of protein and glucose metabolism during surgery: effects of anesthesia.
abstract: The aim of this study was to assess dynamic changes in protein and glucose metabolism during surgery. Twelve patients undergoing colorectal surgery received either intravenous propofol anesthesia (n = 6) or inhalational anesthesia with desflurane (n = 6). Pre- and intraoperative protein and glucose kinetics were analyzed by an isotope dilution technique using L-[1-(13)C]leucine and [6,6-(2)H(2)]glucose. Plasma concentrations of glucose, lactate, free fatty acids, insulin, glucagon, and cortisol were measured before and after 2 h of surgery. The rates of appearance of leucine and glucose, leucine oxidation, protein synthesis, and glucose clearance decreased during surgery, independent of the type of anesthesia (P < 0.05). A correlation between the rate of appearance of leucine and glucose was observed (r = 0.755, P < 0.001). Intraoperative plasma cortisol and glucose concentrations increased (P < 0.05), whereas plasma concentrations of lactate, free fatty acids, insulin, and glucagon did not change. Surgery causes a depression of whole body protein and glucose metabolism, independent of the anesthetic technique. There is a correlation between perioperative glucose production and protein breakdown.
authors.affiliation: Department of Anesthesia, Royal Victoria Hospital, McGill University, 687 Pine Ave. West, Montreal, Quebec, Canada H3A 1A1. thomas.schricker@mcgill.ca
authors.forename: T
authors.initials: T
authors.lastname: Schricker
authors.forename: R
authors.initials: R
authors.lastname: Lattermann
authors.forename: P
authors.initials: P
authors.lastname: Fiset
authors.forename: L
authors.initials: L
authors.lastname: Wykes
authors.forename: F
authors.initials: F
authors.lastname: Carli
mesh_terms: D000328:Adult; D000368:Aged; D000758:Anesthesia; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D001769:Blood / Q000378:metabolism; D001786:Blood Glucose / Q000032:analysis; D003106:Colon / Q000601:surgery*; D000077335:Desflurane; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007432:Intraoperative Period; D007530:Isoflurane / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D015742:Propofol; D011506:Proteins / Q000378:metabolism*; D012007:Rectum / Q000601:surgery*
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D001786:Blood Glucose; D011506:Proteins; D000077335:Desflurane; D007530:Isoflurane; D005947:Glucose; D006854:Hydrocortisone; D015742:Propofol