The Effects of Sevoflurane Anesthesia on Insulin Secretion and Glucose Metabolism in Pigs

Abstract

We investigated the effects of two different concentrations of sevoflurane, 0.4 minimum alveolar anesthetic concentration (MAC) and 1.0 MAC, on insulin secretion before, during, and after sevoflurane anesthesia using three successive intravenous glucose tolerance tests (IVGTT) in pigs with indwelling catheters. We also investigated changes in the levels of plasma glucose, catecholamines (epinephrine [E], norepinephrine [NE]), and cortisol (Cor). The pigs were grouped as awake, 0.4 MAC, or 1.0 MAC. Sevoflurane decreased the ratio of insulin/glucose (INS/GLU) in the basal condition (P < 0.05 awake versus 1.0 MAC) and during IVGTT (P < 0.01 awake versus 1.0 MAC and 0.4 MAC). These decreases were quickly reversible (control levels were regained within 2 h of the end of anesthesia), were probably dose-related, appeared not to be mediated by E, NE, or Cor. In addition, the INS/GLU ratio 2.5-4 h after the end of anesthesia was significantly higher in the anesthetized groups than in the awake group. We conclude that sevoflurane anesthesia has a rapidly reversible inhibitory effect on basal and glucose-stimulated insulin secretion, as do other inhaled anesthetics, and might induce insulin resistance.

Physiological Disturbance May Contribute to Neurodegeneration Induced by Isoflurane or Sevoflurane in 14 Day Old Rats

“…The differences may be from different species, anesthesia doses, or duration. Enflurane [25], isoflurane [26], and sevoflurane [27] may impair glucose tolerance by decreasing insulin secretion and glucose utilization [28], and activating of K-ATP channels [29], [30]. Moreover, this effect of isoflurane or sevoflurane on blood glucose was equal, and did not vary as altering inhaled concentration [31].…”

The Effect of Amino Acid Infusion on Anesthesia-Induced Hypothermia in Muscle Atrophy Model Rats

“…Sevoflurane, one of the volatile inhaled anesthetics, was used in the present study, and our results may have been affected by alteration of a neuroendocrine stress response caused by inhaled anesthesia. A previous study demonstrated that sevoflurane did not stimulate catecholamine (epinephrine and norepinephrine) or cortisol secretion and significantly inhib- ited basal and glucose-stimulated insulin secretion in pigs (32). In addition, pentobarbital significantly increased plasma insulin concentration, while sevoflurane did not increase it, in fed rats (33).…”

Comparison of mechanisms underlying changes in glucose utilization in fasted rats anesthetized with propofol or sevoflurane: Hyperinsulinemia is exaggerated by propofol with concomitant insulin resistance induced by an acute lipid load

“…Volatile anesthetics, such as sevoflurane, attenuate insulin secretion by activating Table 6. Changes in blood glucose levels during insulin tolerance tests in groups S-ITT, SL-ITT, and P-ITT adenosine triphosphate-sensitive potassium channels in β-islet cells (2)(3)(4)(5). We previously found that propofol anesthesia enhances insulin secretion in rats (6,7).…”

“…Volatile anesthetics, such as sevoflurane, activate adenosine triphosphatesensitive potassium channels in β-islet cells, resulting in attenuated insulin secretion (2)(3)(4)(5). Although the precise mechanisms have not been elucidated, insulin secretion is significantly enhanced in rats under propofol anesthesia (6,7).…”