The effect of 1% glucose loading on metabolism in the elderly patients during remifentanil-induced anesthesia : a randomized controlled trial

• Material Type: 博士論文
• Title: The effect of 1% glucose loading on metabolism in the elderly patients during remifentanil-induced anesthesia : a randomized controlled trial
• Author/Editor: Fukuta, Kohei; Kasai, Asuka; Niki, Noriko; Ishikawa, Yuki; Kawanishi, Ryosuke; Kakuta, Nami; Sakai, Yoko; Tsutsumi, Yasuo M.; Tanaka, Katsuya
• Author Heading: Fukuta, Kohei; Kasai, Asuka; Niki, Noriko; Ishikawa, Yuki; Kawanishi, Ryosuke; Kakuta, Nami; Sakai, Yoko; Tsutsumi, Yasuo M.; Tanaka, Katsuya
• Publication, Distribution, etc.: BioMed Central|Springer Nature
• Publication Date: 2020-06-06
• Publication Date (W3CDTF): 2020-06-06
• Alternative Title: レミフェンタニル麻酔中の１％糖負荷が高齢者の代謝に与える影響 : 無作為対照比較試験
• Periodical title: BMC Anesthesiology
• No. or year of volume/issue: 20
• Volume: 20
• Pages: 143-
• ISSN (Periodical Title): ISSN : 1471-2253
• Degree grantor/type: 徳島大学
• Date Granted: 2020-10-22
• Dissertation Number: 甲第3465号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: Glucose; Metabolism; Elderly; Remifentanil
• Target Audience: 一般
• Note (General): Background: Previous studies showed that remifentanil-induced anesthesia can inhibit surgical stress response in non-diabetic adult patients and that low-dose glucose loading during anesthesia may attenuate fat catabolism. However, little is known about the influence of glucose loading on metabolism in elderly patients, whose condition may be influenced by decreased basal metabolism and increased insulin resistance. We hypothesized that, in elderly patients, intraoperative low glucose infusion may attenuate the catabolism of fat without causing harmful hyperglycemia during remifentanil-induced anesthesia. Methods: Elderly, non-diabetic patients scheduled to undergo elective surgery were enrolled and randomized to receive no glucose (0G group) or low-dose glucose infusion (0.1 g/kg/hr. for 1 h followed by 0.05 g/kg/hr. for 1 h; LG group) during surgery. Glucose, adrenocorticotropic hormone (ACTH), 3-methylhistidine (3-MH), insulin, cortisol, free fatty acid (FFA), creatinine (Cr), and ketone body levels were measured pre-anesthesia, 1 h post-glucose infusion, at the end of surgery, and on the following morning. Results: A total of 31 patients (aged 75–85) were included (0G, n = 16; LG, n = 15). ACTH levels during anesthesia decreased significantly in both groups. In the LG group, glucose levels increased significantly after glucose loading but hyperglycemia was not observed. During surgery, ketone bodies and FFA were significantly lower in the LG group than the 0G group. There were no significant differences in insulin, Cr, 3-MH, and 3-MH/Cr between the two groups. Conclusion: Remifentanil-induced anesthesia inhibited surgical stress response in elderly patients. Intraoperative low-dose glucose infusion attenuated catabolism of fat without inducing hyperglycemia.
• Format (IMT): application/pdf
• Access Restrictions: インターネット公開
• Rights (production): © The Author(s). 2020 This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
• Related Material (DOI): 10.1186/s12871-020-01061-3
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 徳島大学 : 徳島大学機関リポジトリ

Table of Contents

http://repo.lib.tokushima-u.ac.jp/files/public/11/115390/20201029161818209665/k3465_abstract_review.pdf fulltext

http://repo.lib.tokushima-u.ac.jp/files/public/11/115390/20201029161818693414/k3465_fulltext.pdf fulltext