Biochemia Medica, Vol. 17 No. 1, 2007.
Original scientific paper
Serum levels of glucose and lactate in patients treated under total intravenous anesthesia with propofol-fentanyl and under balanced anesthesia with isoflurane-fentanyl
Zlata Mujagić
Elsada Čičko
Vesna Vegar-Brozović
Mirsada Prašo
Abstract
Background: To determine pre-, intra- and postoperative serum glucose and lactate concentrations in patients subjected to low abdominal surgery under total intravenous anesthesia (TIVA) with propofol-fentanyl, and in those under general balanced anesthesia with isoflurane-fentanyl.
Materials and Methods: This prospective study included 50 patients of both sexes, aged between 35 and 60 years, subjected to low abdominal surgery. Patients were randomly divided into two groups: experimental group of 25 ASA I/II (American Society of Anesthesiologists I/II classification) patients treated under TIVA, and control group of 25 ASA I/II patients treated under balanced anesthesia. The length of surgery and the degree of surgical trauma did not differ significantly between the two anesthesia groups of patients. Blood samples for glucose and lactate measurements were drawn at exact time points: 30 minutes before the beginning of the surgery (T0), 30 minutes after the beginning of the surgery (T1), at the end of the surgery (T2), 2 hours after the surgery (T3), and 24 hours after the surgery (T4). Serum levels of glucose and lactate were measured using commercially available kits. The results were evaluated with nonparametric Mann-Whitney test.
Results: Serum concentrations of glucose measured at T1, T2 and T3 time points in patients treated under TIVA with propofol-fentanyl were significantly lower (P = 0.03, P = 0.001 and P < 0.001, respectively) than those in patients treated under general balanced anesthesia with isoflurane-fentanyl. The mean circulating level of lactate measured at T4 point in patients treated under TIVA was significantly lower (P = 0.001) than that in patients treated under balanced anesthesia, while T1 lactate was lower in patients treated under balanced anesthesia (P = 0.01). The mean serum concentrations of glucose and lactate measured at T1, T2, and T3 points were significantly higher related to their baseline levels in patients treated under balanced anesthesia (P < 0.001). Both T2 and T3 values of glucose were above the normal range. The mean serum levels of glucose determined at T1, T2, T3, and T4 in patients under TIVA were significantly higher (P < 0.001; P = 0.001) than the baseline level, however, only the level measured at T2 point exceeded the upper nor-mal value. Serum lactate levels measured at T1, T2, T3, and T4 were significan-tly higher than the baseline level (P < 0.001) in patients under TIVA.
Conclusions: The results obtained suggested the metabolic response to sur-gery to be probably attenuated and thus improved in patients treated under TIVA with propofol-fentanyl in comparison with that in patients treated under general balanced anesthesia with isoflurane-fentanyl.
Keywords
glucose; lactate; surgery; propofol-fentanyl anesthesia; isoflurane-fentanyl anesthesia
Hrčak ID:
12914
URI
Publication date:
7.6.2007.
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