Intraoperative infusion of acetated Ringer solution containing glucose and ionized magnesium reduces ketogenesis and maintains serum magnesium.
The effect of glucose infusion during surgery on glucose metabolism has not been investigated sufficiently. We, therefore, examined the effect after the infusion of 1% glucose acetated Ringer solution containing Mg2+ during surgery on ketogenesis and serum Mg2+ concentrations. Patients, classified as ASA I-II, age 51-80 years, were randomly assigned to receive infusion of acetated Ringer solution. The G/Mg group received infusion with 1% glucose, Na+ 140mEq/L, Mg2+ 2 mEq/L, and the C group received infusion with glucose free solution containing Na+ 130 mEq/L without Mg2+. Both solutions were infused at a rate of 25 mL/kg for the first hour, and main-tained at 4 mL/kg/hr thereafter. Blood samples were collected three times: before infusion and at 1 hour and 4 hours after the start of infusion. Electrolytes and glucose metabolism were evaluated at each sampling. After rapid infusion, blood glucose level significantly increased to 170+/-19mg/dL in the G/Mg group, but it returned to close to baseline after 4 hours and serum ketone bodies did not increase during infusion. In the C group, however, blood glucose never increased beyond 110 mg/dL, but both acetoacetic and hydroxybutyric acids increased significantly at the third measurement.
Yokoyama
Takeshi
T
Department of Anesthesiology and Critical Care Medicine, Kochi Medical School, Kohasu, Nankoku, Japan. yokoyamt@kochi-u.ac.jp
Suwa
Kunio
K
Yamasaki
Fumiyasu
F
Yokoyama
Reiko
R
Yamashita
Koichi
K
Sellden
Eva
E
D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001772:Blood Cell Count; D004573:Electrolytes / Q000097:blood; D005260:Female; D005947:Glucose / Q000008:administration & dosage* / Q000378:metabolism*; D006439:Hemodynamics; D006801:Humans; D007328:Insulin / Q000097:blood; D007430:Intraoperative Care / Q000379:methods; D007552:Isotonic Solutions / Q000008:administration & dosage*; D007657:Ketone Bodies / Q000378:metabolism*; D008274:Magnesium / Q000008:administration & dosage* / Q000097:blood*; D008297:Male; D008875:Middle Aged; D000077331:Ringer's Solution
D004573:Electrolytes; D007328:Insulin; D007552:Isotonic Solutions; D007657:Ketone Bodies; C028570:Ringer's acetate; D000077331:Ringer's Solution; D008274:Magnesium; D005947:Glucose