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ID 115390
Title Alternative
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
Author
Fukuta, Kohei Tokushima University
Niki, Noriko Tokushima University
Keywords
Glucose
Metabolism
Elderly
Remifentanil
Content Type
Thesis or Dissertation
Description
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.
Journal Title
BMC Anesthesiology
ISSN
14712253
NCID
AA12034694
Publisher
BioMed Central|Springer Nature
Volume
20
Start Page
143
Published Date
2020-06-06
Remark
内容要旨・審査要旨・論文本文の公開
本論文は,著者Kohei Fukutaの学位論文として提出され,学位審査・授与の対象となっている。
Rights
© The Author(s). 2020
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DOI (Published Version)
URL ( Publisher's Version )
FullText File
language
eng
TextVersion
ETD
MEXT report number
甲第3465号
Diploma Number
甲医第1471号
Granted Date
2020-10-22
Degree Name
Doctor of Medical Science
Grantor
Tokushima University
departments
University Hospital
Medical Sciences