Effect of Preoperative Carbohydrate and Amino Acid Infusion on Postoperative Counter-Regulatory Hormone in Patients Undergoing Elective Thoracoscopic Esophagectomy

Abstract

: Compared with the conventional open surgery, thoracoscopic esophagectomy results in decreased thorax destruction, fewer postoperative complications, and shorter hospitalisation. However, preoperative fasting causes hyperglycemia, prompting attempts to improve postoperative hyperglycemia by preoperatively administering carbohydrate orally or intravenously. Herein, we examined the effect of preoperative carbohydrate and amino acid infusion on counter-regulatory hormone levels in patients undergoing elective thoracoscopic esophagectomy. The glucose and amino acid GA group n 12 were infused with a low concentration of sugar accelerant and amino acid, and the control GAF group n 12 was infused with a sugar-free extracellular uid, until entering the operating room. We evaluated plasma catecholamine 3 fractions, cortisol, and glucose, as well as 3-methylhistidine in the urine. Adrenaline levels were signi cantly higher in the GAF group 263.0 201.8 µIU / ml than in the GA group 114.7 127.0 µIU / ml at the end of the surgery P 0.042 , and at postoperative day POD 1 200.8 137.4 vs. 80.5 64.3 µIU / ml ; P 0.013 . The noradrenalin level was also significantly higher in the GAF group 517.9 523.6 µIU / ml than in the GA group 254.3 205.4 µIU / ml at POD1 P 0.028 , as was the cortisol level 20.0 10.6 µIU / ml vs. 10.2 8.0 µIU / ml ; P 0.015 . No signi cant differences were observed between the two groups in levels of blood glucose or 3-methylhistidine in the urine. Preoperative glucose-amino acid administration improved catabolism suppression in this study.