Effect of desflurane/remifentanil anaesthesia on glucose metabolism during surgery: a comparison with desflurane/epidural anaesthesia

Schricker, Thomas; Galeone, Marina; Wykes, Linda; Carli, Franco

doi:10.1111/j.0001-5172.2004.00297.x

Cited by 21 publications

(12 citation statements)

References 19 publications

(18 reference statements)

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“…). Similar results are widely reported . In a similar study, Koschwanez et al tested the effect of isoflurane and pentobarbitone on blood glucose levels, and used pentobarbitone since it did not cause hyperglycemia for sensor functional efficacy testing .…”

Section: Resultssupporting

confidence: 71%

“…Similar results are widely reported. 14,[30][31][32][33] In a similar study, Koschwanez et al tested the effect of isoflurane and pentobarbitone on blood glucose levels, and used pentobarbitone since it did not cause hyperglycemia for sensor functional efficacy testing. 14 They administered a single IP dose of 0.3 mL of 50 mg/mL pentobarbitone (Nembutal Sodium Solution).…”

Section: Resultsmentioning

confidence: 99%

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Biomimetic electrospun coatings increase the in vivo sensitivity of implantable glucose biosensors

Burugapalli

Wijesuriya

Wang

et al. 2017

J Biomedical Materials Res

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In vivo tissue responses and functional efficacy of electrospun membranes based on polyurethane (PU) and gelatin (GE) as biomimetic coatings for implantable glucose biosensors was investigated in a rat subcutaneous implantation model. Three electrospun membranes with optimized fiber diameters, pore sizes, and permeability, both single PU and coaxial PU‐GE fibers and a solvent cast PU film were implanted in rats to evaluate tissue responses. For functional efficacy testing, four sensor variants coated with the above mentioned electrospun membranes as mass‐transport limiting and outermost biomimetic coatings were implanted in rats. The electrospun PU membranes had micron sized pores that were not permeable to host cells when implanted in the body. However, PU‐GE coaxial fiber membranes, having similar sized pores, were infiltrated with fibroblasts that deposited collagen in the membrane's pores. Such tissue response prevented the formation of dense fibrous capsule around the sensor coated with the PU‐GE coaxial fiber membranes, which helped improve the in vivo sensitivity for at least 3 weeks compared to the traditional sensors in rat subcutaneous tissue. Furthermore, the better in vitro sensor's sensitivity due to electrospun PU as the mass‐transport limiting membrane translated to better in vivo sensitivity. Thus, this study showed that electrospun membranes can play an important role in realizing long in vivo sensing lifetime of implantable glucose biosensors. © 2017 The Authors Journal of Biomedical Materials Research Part A Published by Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 1072–1081, 2018.

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Section: Resultssupporting

confidence: 71%

Section: Resultsmentioning

confidence: 99%

Biomimetic electrospun coatings increase the in vivo sensitivity of implantable glucose biosensors

Burugapalli

Wijesuriya

Wang

et al. 2017

J Biomedical Materials Res

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“…The results showed that isoflurane anesthesia impairs adenosine triphosphate-sensitive potassium channel activity in pancreatic β-cells; so secretion of insulin decreases and hyperglycemia occurs [15]. Schricker et al [16] demonstrated that enough analgesia with remifentanil or epidural analgesia can prevent hyperglycemia during the surgery. So it can be concluded that hyperglycemia during inhalation anesthesia may be due to surgical pain and stimulation of sympathic system.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Propofol and Isoflurane on Blood Glucose during Abdominal Hysterectomy in Diabetic Patients

et al. 2014

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BackgroundAcute hyperglycemia in the perioperative period is associated with significantly increased complications. In few human studies the effects of propofol and inhalational anesthetic on the glucose metabolism were compared. In this study we evaluated the effect of propofol and isoflurane on blood glucose during abdominal hysterectomy in diabetic patients.MethodsAfter approval by the Ethical Committee and written informed consent, thirty 35 to 65 years old diabetic women underwent for elective abdominal hysterectomy under general anesthesia were studied in this randomized single blind clinical trial study. The plasma glucose was maintained at 100 to 180 mg/dL during the operation. Anesthesia protocol was similar in two groups except maintenance of anesthesia that was with infusion of propofol in the propofol group and with isoflurane in the isoflurane group. Blood glucose level and the rate of insulin intake during surgery compared between two groups.ResultsMean blood glucose before induction of anesthesia did not have significant difference between two groups, but 60 and 90 minutes after starting the operation blood glucose in the propofol group was significantly lower than isoflurane group. Also with using Repeated Measure test, two groups was significantly different according to blood glucose (P=0.045). Mean of administration of insulin during the surgery did not have significant difference between two groups by using repeated measure test and P=0.271. Also mean of bispectral index in different times during the surgery between two groups didn't have significant difference (P=0.35 repeated measure test).ConclusionBlood glucose increased during maintenance of anesthesia with isoflurane compared to propofol during the surgery.

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“…However, plasma insulin and glucagon concentrations did not change significantly during this period. Schricker et al [12] also found that plasma insulin and glucagon concentrations remained unchanged while blood glucose concentration increased significantly during elective colorectal surgery in patients undergoing desflurane anesthesia supplemented with remifentanil or epidural anesthesia. During surgery, the endocrine milieu is characterized by increased plasma concentrations of cortisol, adrenaline and noradrenaline [13].…”

Section: Discussionmentioning

confidence: 99%

“…On the contrary, however, after the intraoperative infusion of 10% amino acids at a rate of 0.02 ml·kg –1 ·min –1 (1.2 ml·kg –1 ·h –1 ), the baseline values of EGP were found not to be modified while glucose clearance decreased [10]. Anesthesia itself could decrease EGP by inhibiting gluconeogenesis [12,17], and therefore it might increase the available amino acids for the synthetic pathways [10]. However, the infusion of more amino acids may lead to more substrates for gluconeogenesis and higher EGP, ultimately resulting in hyperglycemia.…”

Section: Discussionmentioning

confidence: 99%

Effect of Intraoperative Amino Acid Infusion on Blood Glucose under General Anesthesia Combined with Epidural Block

Zhong¹,

Ge²,

Zhuang³

et al. 2012

Ann Nutr Metab

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Aim: To investigate the effect of intraoperative amino acid infusion on blood glucose in patients under general anesthesia combined with epidural block. Methods: 36 patients were randomly assigned to receive an intraoperative infusion of 18 compound amino acids (group AA) or lactated Ringer solution (group LR) at 2 ml·kg^–1·h^–1. Nasopharyngeal temperature, and blood glucose, plasma insulin, C-peptide and glucagon concentrations were measured 30 min before induction (T0), 10 min after induction (T1), 30 min and 2 h after skin incision (T2, T3), and 30 min and 2 h postoperatively (T4, T5). Results: Nasopharyngeal temperature values, which decreased during surgery in both groups, were significantly higher in group AA than in group LR from T3 to T5. Compared with T0, the blood glucose concentration increased significantly from T2 in group AA and T3 in group LR to T5. Plasma insulin and C-peptide concentrations did not change significantly in group LR, while both increased significantly in group AA from T1 to T4. The plasma glucagon concentration did not change significantly in either group. Conclusion: Intraoperative amino acid infusion in patients under general anesthesia combined with epidural block may accelerate the increase of blood glucose concentration and stimulate insulin secretion, and can alleviate hypothermia during the later period of surgery and postoperatively.

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Effect of desflurane/remifentanil anaesthesia on glucose metabolism during surgery: a comparison with desflurane/epidural anaesthesia

Cited by 21 publications

References 19 publications

Biomimetic electrospun coatings increase the in vivo sensitivity of implantable glucose biosensors

Biomimetic electrospun coatings increase the in vivo sensitivity of implantable glucose biosensors

The Effects of Propofol and Isoflurane on Blood Glucose during Abdominal Hysterectomy in Diabetic Patients

Effect of Intraoperative Amino Acid Infusion on Blood Glucose under General Anesthesia Combined with Epidural Block

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