Insulin secretion and glucose utilization are impaired under general anesthesia with sevoflurane as well as isoflurane in a concentration-independent manner.
OBJECTIVE
The dose-dependent effects of sevoflurane and isoflurane anesthesia on glucose tolerance were compared in humans.


METHODS
A prospective, randomized clinical study was conducted in 30 patients. The 30 patients were divided randomly into three sevoflurane anesthesia groups (0.5, 1.0, and 1.5 minimum alveolar concentration [MAC]) and three isoflurane anesthesia groups (0.5, 1.0, and 1.5 MAC). Induction of anesthesia was accomplished by inhalation of the volatile agent and nitrous oxide. After induction, anesthesia was maintained at the designated MAC for 15 min without surgical stimulation. The intravenous glucose tolerance test (IVGTT) was performed in these 30 patients while they were under general anesthesia and again several days after surgery in 5 of these patients while they were awake, as a control.


RESULTS
The insulinogenic index (change in concentration of immunoreactive insulin/change in glucose concentration), the acute insulin response, and rates of glucose disappearance were significantly lower in all anesthesia groups than in the control group. However, the insulinogenic index, acute insulin response, and the glucose disappearance rate did not differ significantly among the six anesthesia groups.


CONCLUSIONS
Sevoflurane anesthesia impairs glucose tolerance to the same degree as does isoflurane anesthesia. Glucose intolerance during sevoflurane or isoflurane anesthesia is independent of agent and dosage up to 1.5 MAC.
Tanaka
Tadashi
T
Department of Anesthesiology, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo 105-8461, Japan.
Nabatame
Hideki
H
Tanifuji
Yasumasa
Y
D000768:Anesthesia, General / Q000009:adverse effects*; D018685:Anesthetics, Inhalation; D001786:Blood Glucose / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D005947:Glucose / Q000378:metabolism*; D018149:Glucose Intolerance / Q000097:blood / Q000209:etiology*; D005951:Glucose Tolerance Test; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood / Q000378:metabolism*; D000078790:Insulin Secretion; D007530:Isoflurane; D008297:Male; D008738:Methyl Ethers; D011446:Prospective Studies; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D001786:Blood Glucose; D007328:Insulin; D008738:Methyl Ethers; D000077149:Sevoflurane; D007530:Isoflurane; D005947:Glucose