Fujita Yasuki, Yamaguchi Sayo, Nakamura Kayo, Horiguchi Yuu, Ikeda Daisuke, Kaneko Michiko, Tomioka Keiko, Tokunaga Chiharu, Iwakura Takeo
Department of Anesthesiology, Saiseikai Nakatsu Hospital, Osaka 530-0012.
Masui. 2012 Jan;61(1):68-73.
We investigated whether the perioperative amino acid infusion with glucose is effective for preventing perioperative hypothermia and postoperative infection in patients undregoing total knee arthroplasty (TKA).
Forty patients undergoing TKA under general anesthesia were enrolled in this study. The patients were randomly allocated to two groups: AA group (n = 22), to which amino acid was infused, and AAGlu group (n = 18), to which amino acid and glucose were infused. The infusions were started before the anesthetic induction. Remifentanil was administered during the surgery, and the dose of remifentanil was adjusted to keep stable hemodynamics. The levels of blood glucose and body temperature were evaluated. We also recorded the frequency of additional use of nonsteroidal anti-inflammatory drugs, the days required until the wound closure, and complications in the post-operative period.
The levels of blood glucose in AAGlu group were significantly higher than those of AA group (P < 0.05). However, no significant differences were found in perioperative body temperature, postoperative days required until the wound closure and the frequency of additional use of analgesics between the groups.
These results suggest that in patients undergoing TKA receiveing amino acid infusion perioperatively, thermogenic effect and prevention of postoperative infection are similar whether exogenous glucose is infused or not.
我们研究了围手术期输注氨基酸加葡萄糖对全膝关节置换术（TKA）患者围手术期体温过低及术后感染的预防效果。
本研究纳入40例在全身麻醉下接受TKA的患者。患者被随机分为两组：输注氨基酸的AA组（n = 22）和输注氨基酸加葡萄糖的AAGlu组（n = 18）。输注在麻醉诱导前开始。术中给予瑞芬太尼，并调整瑞芬太尼剂量以维持血流动力学稳定。评估血糖和体温水平。我们还记录了非甾体类抗炎药的额外使用频率、伤口愈合所需天数以及术后并发症。
AAGlu组的血糖水平显著高于AA组（P < 0.05）。然而，两组之间围手术期体温、伤口愈合所需术后天数以及镇痛药额外使用频率均未发现显著差异。
这些结果表明，对于围手术期接受氨基酸输注的TKA患者，无论是否输注外源性葡萄糖，产热效果及预防术后感染的效果相似。
