Metabolic Stress Response Attenuate by Oral Glucose Preoperatively in Patient Underwent Major Surgery with General Anesthesia

Widnyana, I Made Gede; Senapathi, Tjokorda Gde Agung; Aryabiantara, I Wayan; Wiryana, Made; Sinardja, Ketut; Budiarta, I Wayan; Aribawa, IGN Mahaalit; Sucandra, Made Agus Kresna; Parami, Pontisomaya; Artawan, I Made

doi:10.21767/2471-982x.100015

Cited by 5 publications

(3 citation statements)

References 5 publications

(9 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…показали, що пероральне застосування глюкози до операції знижує гіперглікемію та підвищення кортизолу після операції порівняно з пацієнтами, які голодують перед операцією. Більше того, автори продемонстрували більш виражений ефект від застосування глюкози двічі (ввечері та вранці) до операції у зниженні підвищення рівня кортизолу та глікемії після операції порівняно з пацієнтами, які приймали глюкозу тільки один раз перед операцією вранці [15]. У власному дослідженні, наведеному в цій…”

Section: результати дослідження та їх обговоренняunclassified

Stress-response during the Nuss procedure under the combination of general anesthesia with different regional blocks

Myhal¹

2021

View full text Add to dashboard Cite

The perioperative stress-response is a dynamic process under the influence of patient-specific, surgical and anaesthesiologic factors. Purpose – to evaluate stress response during the correction of pectus excavatum by Nuss under the combination of general anesthesia with different variants of the regional block. Materials and methods. The observative prospective study included 60 adolescents (boys/girls=47/13) undergone Nuss procedure under the combination of general anesthesia and regional blocks. The patients were randomized into three groups (n=20 in each) according to the perioperative regional analgesia technique: standard epidural anesthesia (SEA) in Th5–Th8, high epidural anesthesia (HEA) in Th2–Th3, and bilateral paravertebral anesthesia (PVA) in Th5–Th8. The serum cortisol and glycemia were analyzed at three stages: 1 – baseline before surgery, 2 – during bar rotation, and 3 – after surgery finished. Results. The average serum cortisol level among all patients before surgery was 342.4 [282.1–415.0] nmol/L. At stage 2 the plasma cortisol decreased up to 223.1 [174.9–282.3] nmol/L (p<0.000001). After the surgery and anesthesia finished the average plasma cortisol was 279.6 [216.7–312.6] nmol/L (p<0.000001 vs baseline). During surgery serum cortisol decreased in group SEA by 41%, in group HEA – by 30%, and in group PVA – by 31% compared with baseline levels. After surgery, the serum cortisol was lower than baseline measurements in group SEA by 28%, in group HEA – by 20%, and in group PVA – by 26%. The average baseline glycemia among all patients before surgery was 4.62 [4.01–5.05] mmol/L. At stage 2 glycemia decreased significantly up to 4.05 [3.86–4.62] mmol/L (p=0.00018). After the surgery finished the average serum glucose among all patients was 4.24 [4.09–4.99] mmol/L (p=0.7). At stage 2 serum glucose decreased in group SEA by 11%, in groups HEA and PVA – by 5% compared with the baseline level. The dynamics of serum cortisol and glycemia were similar in all groups with statistically insignificant intergroup differences at all three stages. Conclusions. Serum cortisol and glycemia during the Nuss procedure under the combination of general anesthesia with regional blocks decreased significantly. After surgery finished glycemia returned to baseline level, but serum cortisol was lower than baseline measurement. The changes in serum cortisol and glycemia were more pronounced in patients under standard epidural analgesia in Th5–Th8 compared with the high epidural in Th2–Th3 and paravertebral blocks. The study was conducted in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the institution. Informed consent of parents and children was obtained for the study. The author declares no conflict of interest. Key words: cortisol, glycaemia, pectus excavatum, Nuss procedure, regional anaesthesia.

show abstract

Section: результати дослідження та їх обговоренняunclassified

Stress-response during the Nuss procedure under the combination of general anesthesia with different regional blocks

Myhal¹

2021

View full text Add to dashboard Cite

show abstract

“…Return of normal bowel function is desirable in colorectal surgeries, which is governed by preoperative fasting, bowel preparation, analgesia and anesthetic approaches. 17,18 Preoperative carbohydrates are provided with the sole aim of minimizing stress response, avoiding catabolic state, negative nitrogen balance and insulin resistance, thereby minimizing loss of lean muscle mass.…”

Section: Enhanced Recovery After Anesthesia and Surgerymentioning

confidence: 99%

Stress or metabolic response to surgery and anesthesia

Gupta¹,

Gupta²,

Gupta³

2019

IJCA

View full text Add to dashboard Cite

The stress response to surgery, trauma, burns, and critical illness is a well-known entity and encompasses derangements in metabolic and physiological pathways which leads to inflammatory, acute phase, hormonal and genomic responses. There is a state of hyper catabolism and hyper metabolism, which results in impaired wound healing, impaired immune functions and muscle wasting. The stress response to surgery is similar to that induced as a result of traumatic injuries, however it depends on the duration and severity of surgical or traumatic injury. Body responds to such stimuli which may range from minor to massive insults and response is characterized by local or generalized responses. The generalized responses vary from endocrinal, metabolic and biochemical changes in the body and magnitude of the same vary dep/ending on the intensity, severity and duration of stimuli. Stress responses are known to be well tolerated in normal healthy adults, however in patients with known ailments and co-morbidities such as coronary heart disease, hypertension, diabetes, liver diseases, renal insufficiency, old age, changes may be detrimental and life threatening.

show abstract

“…Роль кортизолу в стресових ситуаціях полягає в тимчасовому збільшенні вироблення енергії за рахунок обмеження процесів, які не потрібні для негайного виживання [8]. Кортизол підвищує рівень глюкози внаслідок глюконеогенезу, пригнічує імунну систему, підвищує метаболізм жирів, білків і вуглеводів [5].…”

unclassified

Influence of components of anesthesia on dynamics of stress markers in gynecological laparoscopic surgery.

Khalimonchyk¹,

Кlygunenko²

2019

Medicni Perspektivi (Medical Perspectives)

View full text Add to dashboard Cite

Metabolic Stress Response Attenuate by Oral Glucose Preoperatively in Patient Underwent Major Surgery with General Anesthesia

Cited by 5 publications

References 5 publications

Stress-response during the Nuss procedure under the combination of general anesthesia with different regional blocks

Stress-response during the Nuss procedure under the combination of general anesthesia with different regional blocks

Stress or metabolic response to surgery and anesthesia

Influence of components of anesthesia on dynamics of stress markers in gynecological laparoscopic surgery.

Contact Info

Product

Resources

About