Experimental study of efficacy and optimal dose of intraoperative glucose in rabbits under general anesthesia

Abstract

This experimental study was designed to investigate the efficacy of glucose loading during surgery. Rabbits, fasted overnight, received 20 ml·kg·h fluid infusion containing glucose at various concentration (0,0.5, 1.0, 1.5, 2.0% w/v) for 3 h intraoperatively. Plasma glucose level increased after the beginning of operation, but the increase was slight in groups given 0.2 g·kg·h or lower doses of glucose. Glucose at higher doses caused marked hyperglycemia. These higher doses also promoted urinary glucose excretion, and in the group given the maximum glucose dose (0.4 g·kg·h), this parameter was significantly elevated compared with findings in the 0.2 g·kg·h group (P<0.05), whereas it showed no significant difference among groups given 0-0.2g·kg·h. The liver glycogen content in animals that received no glucose was significantly lower than that of the 0.2 g·kg·h group (P <0.01). However, there was no correlation between glycogen level and glucose dose among groups receiving glucose. These results suggest that intraoperative glucose supplementation is effective in preventing glycogen depletion, and indicate that, to avoid glucose overloading, the optimal dose is 0.1-0.2 g·kg·h.

Optimal dose and duration of glucose administration during fasting period preceding surgery in rabbits

“…For example, it is often low during trauma, surgery, and other states. In a previous study we confirmed that alterations can be induced in the glucose tolerance limit by demonstrating that administration of no glucose caused an intraoperative increase in plasma glucose level [5], and in the present study by demonstrating that plasma glucose level does not change with infusion of 0.2 g·kg Ϫ1 ·h Ϫ1 glucose or less.…”

“…However, in many circumstances, intraoperative glucose administration may be advantageous to inhibit catabolism and improve fat and carbohydrate metabolism [2][3][4]. Our previous animal study also showed that intraoperative glucose supplementation is effective in preventing hepatic glycogen depletion, and indicated further that the optimal dose to avoid glucose overloading was 0.1-0.2 g·kg Ϫ1 ·h Ϫ1 [5]. These findings confirm the necessity of intraoperative glucose infusion in clinical settings.…”

“…Plasma nonesterified fatty acids and ketone bodies (acetoacetic acids and -hydroxybutyric acids) were measured enzymatically using a commercially available kit (NEFA C-Test: Wako Pure Chemical Co., Ketone Test: Sanwa Chemical Co., Nagoya, Japan). Hepatic glycogen content was determined by a method previously reported [5]. The frozen liver samples and the purified glycogen (Wako) used as standards were solubilized with 30% (w/v) KOH by boiling at 100°C for 30 min.…”

What is the optimal dose of glucose administration during minor surgery under sevoflurane anesthesia?

“…Accordingly, it is thought to be reasonable to administer a glucose solution to patients before [1] and during anesthesia to replenish the fuel level [2].…”

“…In patients undergoing major surgery or who are critically ill, several investigators have suggested that the use of smaller doses of glucose could prevent unexpected harmful effects [2,8].…”