2. Department of Pathophysiology (Anesthesiology), Nagoya City University School of Nursing, Nagoya, Japan.
Background: The aim of this prospective randomized controlled study was to examine the optimal rate of glucose administration for preventing catabolism under general anaesthesia maintained with remifentanil.
Methods: Forty-five consecutive patients who were scheduled to undergo elective head and neck surgery were enrolled. The patients were divided into three groups and were treated with a glucose-free solution (Group G0) or a glucose solution at a rate of 0.07 g/kg/h (Group G1) or 0.14 g/kg/h (Group G2). The patients’ plasma glucose, the plasma levels of ketone bodies, free fatty acids (FFA), 3-methylhistidine (3- MH), creatinine (Cr), Branched-Chain Amino Acid (BCAA), and stress hormones were measured every two hours until 6h (T6).
Results: The plasma glucose levels of Group G2 were significantly higher than those of the other groups at T2, T4, and T6 (P<0.01); however, the plasma glucose levels of the three groups did not differ at POD1. Group G0 exhibited significantly higher plasma ketone body and BCAA levels (at T2, T4, and T6) and FFA levels (at T4 and T6). No significant inter-group differences in the plasma levels of 3-MH/Cr or stress hormones were observed.
Conclusions: Intraoperative glucose administration at a rate of 0.07 g/kg/h under general anaesthesia inhibited catabolism without the risk of hyperglycaemia.
Keywords: Intraoperative nutrition, glucose, metabolism, remifentanil