Effect of Epidural Analgesia on Postoperative Insulin Resistance as Evaluated by Insulin Clamp Technique

Metabolic syndrome in women with chronic pain

“…Both obesity and physical inactivity predispose to the development of insulin resistance, which, in turn, appears to be a driving force in the development of dyslipidemia and hypertension [9]. Pain accompanying physical trauma, such as surgery [10], as well as acute experimental pain [11], also has been found to induce insulin resistance. Furthermore, chronic widespread pain has been diagnosed in 62% of diabetic women and labeled as fibromyalgia in 17% to 23% [12][13][14].…”

An Experimental Model of Intestinal Resection and Compensated Non-Hypotensive Blood Loss

“…Surgery involves a number of events, including anesthesia, soft tissue trauma, and blood loss that by themselves or in combination may result in metabolic changes such as hyperglycemia and insulin resistance [1][2][3][4]. Perioperative blood loss in the range of 20% to 40% of total blood volume is common during major upper abdominal surgery [5][6][7][8] and in the range of 5% to 10% during minor procedures [9,10].…”

Perioperative amino acid supplementation of hypocaloric glucose does not impair glucose metabolism after surgery

“…All patients received epidural anesthesia during surgery followed by continuous postoperative epidural analgesia with potential impact on glucose homeostasis. Effective segmental blockade of efferent and afferent fibers by epidural local anesthetic has been shown to attenuate the hyperglycemic response to abdominal surgery by improving glucose utilization and preventing the increase in glucose production [15,19,20].…”