Glucose infusion instead of preoperative fasting reduces postoperative insulin resistance

摘要: In severe catabolic states, such as burn injury, sepsis and accidental a state of marked insulin resistance is encountered. Insulin also present after elective surgical treatment, more pronounced with increasingly greater magnitude operation performed. Results recent animal experiments have shown that even short periods food deprivation, reducing carbohydrate reserves, alter responses to stress. This notion resulted in our questioning the rationale depletion associated overnight preoperative fasting. Twelve patients undergoing open cholecystectomy were randomly given no infusion (control group) or 5 milligrams per kilogram minute glucose (glucose during sensitivity (M value, milligram minute) was determined using hyperinsulinemic normoglycemic clamp (plasma level, 65 microunits milliliter blood 4.5 millimoles liter) before first postoperative day. Preoperative similar two groups. Postoperatively, M values decreased by 55 +/- 3 percent 32 4 (p < 0.01). Plasma levels insulin, c-peptide, glucagon, growth hormone, catecholamines cortisol connection clamps both groups preoperatively postoperatively. The results indicate active preservation may improve metabolism because occurrence reduced infusion.