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

Abstract

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.

Intraoperative thermal insulation in off-pump coronary artery bypass grafting surgery: a prospective, double blind, randomized controlled, single-center study

“…It is suggested that intraoperative amino acid infusion is beneficial to maintain normal perioperative temperature in patients undergoing gastrointestinal surgery without increasing the risk of hyperglycemia or causing damage to liver and kidney function. It is safe to prevent perioperative hypothermia (15). In 2008, amino acid was also reported in related applications in OPCAB (16).…”

“…Intraoperative infusion of amino acid injection is also one of the most popular perioperative insulation measures in recent years (14)(15)(16). Some studies have proved the effectiveness and safety.…”

Insulin Resistance, Glycemia and Cortisol Levels in Surgical Patients who Had Preoperative Caloric Load with Amino Acids

“…In our study, the postoperative blood glucose values were increased in the control group (from 5.21 mmol/l to 5.77 mmol / l), while in the study group were decreased (from 5.39 mmol / l to 4.79 mmol/l). Maitra et al [20], Zong et al [21] and Srceva et al [22] argue that the administration of different fluids in the pre-operative period differently affect the blood sugar levels. From this study and the studies of Srceva [22] and Zong [21] we can clearly conclude that pre-operatively given amino acids has strong positive impact on the postoperative blood glucose levels.…”

Intraoperative infusion of branched-chain amino acids in patients undergoing gastrointestinal tumor surgery

“…In our previous study of patients undergoing surgery under general anesthesia combined with epidural block, the thermogenic effects of intraoperative AAs infusion were not significant in the early part of surgery; they were most obvious at 2 h after the induction of anesthesia [ 14 ]. This was consistent with our results.…”

“…In previous studies [ 10 ], the standard deviation of body temperature was approximately 0.1–0.2 °C, and the expected difference between groups was approximately 0.3–0.5 °C; therefore, less than nine patients in each group were calculated to be sufficient for this outcome (power 80 %, α = 0.05). On the basis of an expected difference in blood glucose concentration of 1 mmol·L −1 between the two groups (standard deviation =1 mmol·L −1 ; power 80 %, α = 0.05), 17 patients in each group were calculated to be sufficient for this study [ 10 , 13 , 14 ]. Thus, 20 patients in each group were deemed sufficient for this study.…”