title: Intraoperative infusion of acetated Ringer solution containing glucose and ionized magnesium reduces ketogenesis and maintains serum magnesium.
abstract: 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.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Kochi Medical School, Kohasu, Nankoku, Japan. yokoyamt@kochi-u.ac.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yokoyama
authors.forename: Kunio
authors.initials: K
authors.lastname: Suwa
authors.forename: Fumiyasu
authors.initials: F
authors.lastname: Yamasaki
authors.forename: Reiko
authors.initials: R
authors.lastname: Yokoyama
authors.forename: Koichi
authors.initials: K
authors.lastname: Yamashita
authors.forename: Eva
authors.initials: E
authors.lastname: Sellden
mesh_terms: 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
chemical_list: D004573:Electrolytes; D007328:Insulin; D007552:Isotonic Solutions; D007657:Ketone Bodies; C028570:Ringer's acetate; D000077331:Ringer's Solution; D008274:Magnesium; D005947:Glucose