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

Abstract

BackgroundThe purpose of this study is to investigate the effects of intraoperative infusion of branched-chain amino acids (BCAA) in patients undergoing gastrointestinal tumor surgery.MethodsSixty-one patients with gastrointestinal tumors undergoing gastrointestinal surgery were enrolled and randomly assigned to receive an intraoperative infusion of 3-compound BCAA solution (N = 20), amino acids (AA) solution (N = 21), or normal saline (NS) (N = 20). Nasopharyngeal temperature, blood glucose (BG), plasma insulin, and blood free fatty acids (FFA) concentrations were measured at 30 min before and 10 min after induction (T0,T1), 30 min and 2 h after skin incision (T2,T3), and 1 h after tracheal extubation (T4). Intensity of shivering and pain was accessed at 1 h after extubation.ResultsThe temperature in the BCAA and AA group was significantly higher than that in the NS group at T4 (P = 0.014 and 0.033). The incidence of shivering in the BCAA and AA group was significantly lower than in the NS group (P = 0.027 and 0.012). BG increased in AA group at T3 and T4 (P = 0.001 and 0.045). The plasma insulin concentration increased in the BCAA and AA group from T1 to T3. The plasma FFA concentrations in the BCAA group were lower than in the AA and NS group from T2 to T4.ConclusionsIntraoperative BCAA and AA infusion alleviated postoperative hypothermia and shivering. BCAA infusion also inhibited fat mobilization, without adversely affecting blood glucose.Trial registrationChiCTR-TRC-14004668Electronic supplementary materialThe online version of this article (doi:10.1186/s12957-015-0751-y) contains supplementary material, which is available to authorized users.

Are Supplemental Branched-Chain Amino Acids Beneficial During the Oncological Peri-Operative Period: A Systematic Review and Meta-Analysis

“…A total of 276 studies were included in the larger project, with 20 relevant BCAAs articles included here reporting on 19 studies. These comprised 13 RCTs 53 -65 and 6 observational cohort studies in 7 reports 66 -72 on BCAAs, and included 2019 total participants overall across the studies.…”

“…Six RCTs (46%) had sample sizes <50, while the largest 3 had 145, 124, and 96 total randomized participants. The large majority of the RCTs dealt with liver cancer (10/13, 77%), 2 were on gastrointestinal cancer, 63,65 and 1 on bladder cancer. 54 Mean (or median) ages of the study populations were from 53 to 67 years old, and all of the RCTs had a predominantly male population.…”

Effect of an intraoperative infusion of amino acids on body temperature, serum biochemistry, serum insulin and recovery variables in healthy dogs undergoing ovariohysterectomy

“…15 AA NIT has been employed to anaesthetised human beings, resulting in improved temperature management, decreased infection rates, reduced intraoperative bleeding, decreased shivering during recovery and shorter recovery times. [16][17][18][19] These beneicial efects have been demonstrated in patients with as little as a 0.3-0.8°C improvement in body temperature (BT). 16 17 20 In dogs, AA NIT has been shown to attenuate hypothermia when administered at various rates and times.…”

“…Amino acids (AA) and protein appear to have a greater thermic effect (20–30 per cent increase over baseline energy expenditure) than carbohydrates (5–10 per cent) or lipids (0–3 per cent) and thus have been the preferred nutrient used in research and clinical studies 15 . AA NIT has been employed to anaesthetised human beings, resulting in improved temperature management, decreased infection rates, reduced intraoperative bleeding, decreased shivering during recovery and shorter recovery times 16–19 . These beneficial effects have been demonstrated in patients with as little as a 0.3–0.8°C improvement in body temperature (BT) 16 17 20 .…”