Blood glucose levels during methoxyflurane anaesthesia

Abstract

HYPERGLYCAEMIA has long been recogmzed as one of. the chmf responses to the metabohc stress of anae~thesaa Dlethyl ether especmlly will produce increases 1 n the blood sugar of ut to 100 per cent during the fllrst half-hour to 45 minutes o[~anaeskhesaa and for th~s reason ats effect on carbohy[drat{, metabohsm has been s~Ldled extensively 1 Experiments done on dogs m th~l' 192,0 s seemed to mdmate that thus hyperglycaemm was related to, or caused by, a profound metabohe aeLdosls which appeared qmte early during the adm~l~astratmn of ether 2 a 4 This e:cplanaaon was w,~dely accepted as applying to man until Beecher and his co-workers demonstrated that ~her~ is no slgmficant metabohe acidosis during the admmastrahon of efher to adults, although some degree of acidosis does occur m children 5 e Prior to Beecher's reports, at hgd been shown m rabbats that both adrenalectom)i and spinal anaesthesaa prelducmg a T4 sensory level woutd protect against hyperglycaemaa during ether anaesthesm 7 This observation has been confirmed repeatedly by the use of beth local anaesthetms and a,drenergm blocking agents s 0 Today, therefore, it ~as generally concluded that ihe hyperglycaemm produced by ether anaesthesm as mostly the result of the hberatton of catecholammes ~oOther general anaestheaes are also capable of p~loduemg a hyperglycaemm l esponse Cyclopropane anaesthesm m man cheats an increase m the Mood sugar %ompa~able to that reduced by ether" according to Greene al Reports concernmg "the effect of halothane are somewhat davergent Some studms have shown no effect on blood sugar during halothane anaesthe,,m, while other evaluatmns have shown that there as some hype~:glycaemm response to halothane m This, however, as not as great as that seen wath ether and cyelopropane ~ ~4 It is of anterest to note that the hyperglycaem~a produced by these agents seems to para~el thear effect on sympathetic actrvlty, for~ at has been shown that both ether and cyclowopane produce a marked increase m the level of circulating cateeholammes, wh~le halothane does not ~5 Methox),flurane combines some of the structural and anaesthetm charactenstacs of both dlethyl ether and halothane, smee at as a halogenated methyl ethyl e~mr Its effect on carbohydrate metabohsm, however, has not yet been studmd care}ully In one early report of a chmeal trml of methoxyflu~ane in 20~ patmnts the b]ood sugar was measured an ~ In 8 of these a moderate rise of about 85 mg ~g occurred 1~ Another study with dogs indicated that Mood sugar was unchanged during spontaneous respiration but decreased wath a~s~sted resp~ratmn ~7 ~From the Department of Anesthesiology, 'The Umverslty of Mmhlgan MedmaI School, Veterans Administration Hospital, Ann Arbor, Michigan 7 Can Anaes S~c J, vo] 11, no 1, Jam~ary, !964

Η Προεγχειρητικη Νηστεια Και Αι Διακυμανσεις Των Τιμων Σακχαρου Αιματος Εις Τα Παιδια Προ Και Κατα Την Επεμβασιν Υπο Γενικην Αναισθησιαν

“…οτι ή χορήγησις αΙθέρος έπί απουσίας ένδοκοιλιακής επεμβάσεως δέν οδη γεί εις άξιόλογον άνύψωσιν του σακχάρου αίματος. 42 Το αυτό παρετηρήθη και μετά τήν χορήγησιν Halothane, 80 • 85 Methoxyflurane 73 και Thiopen tone. 50 • 85 Πλείστοι οσοι έρευνηταί, έν συνεχεία, υπεστήριζαν οτι ή προκα λούμενη ύπεργλυκαιμία οφείλεται εις αυτήν ταύτην τήν έγχείρησιν δηλαδή τήν άπελευθέρωσιν κατεχολαμινών έκ τής ένεργοποιήσεως του συμπαθη τικού καί δτι τα γενικά αναισθητικά, αυτά καθ' έαυτά, δέν προκαλούν ύπεργλυκαιμίαν.…”