Department of Anesthesia, Zhongshan Hospital, and Department of Anesthesiology, Shanghai Medical College, Fudan University, Shanghai, China.
Ann Nutr Metab. 2012;61(2):117-25. doi: 10.1159/000341566.
Intraoperative amino acid infusion can attenuate the decrease in core temperature, but the metabolic effects are uncertain.
Thirty-six healthy mongrel dogs undergoing ileectomy under general anesthesia were infused intraoperatively with normal saline or 18 compound amino acids at 6, 12, and 24 kJ·kg⁻¹·h⁻¹ (NS, 6-, 12-, and 24-kJ groups) and studied until 24 h after the operation. Blood glucose, plasma insulin, free fatty acids, and triglyceride concentrations were determined at 7 defined time points. Muscle aminograms, urinary urea, and 3-methylhistidine excretions were measured before and after the operation.
Blood glucose and plasma insulin increased amino acid dose dependently during the operation and in the early period after the operation. Free fatty acids were significantly lower in the 12- and 24-kJ groups compared with the NS group at the end of the operation. The negative nitrogen balance was alleviated dose dependently in the amino acid groups on operation day. The urinary 3-methylhistidine decreased significantly during the first 24 h after the operation in the 24-kJ group, while it increased in the other groups with the largest increase in the NS group. Basic, branched-chain, and aromatic amino acids in the vastus lateralis muscle increased dose dependently at the end of the operation in the amino acid groups.
Intraoperative amino acid infusion has the dose-dependent effects of increasing blood glucose, inhibiting fat mobilization and muscle protein breakdown.
术中氨基酸输注可以减轻核心体温的下降,但代谢效应尚不确定。
36 只健康杂种犬在全身麻醉下接受回肠切除术,术中分别输注生理盐水或 18 种复合氨基酸(6、12 和 24 kJ·kg⁻¹·h⁻¹;NS、6-、12-和 24-kJ 组),并在术后 24 小时进行研究。在 7 个特定时间点测定血糖、血浆胰岛素、游离脂肪酸和甘油三酯浓度。在手术前后测定肌肉氨基酸谱、尿尿素和 3-甲基组氨酸排泄量。
术中及术后早期,血糖和血浆胰岛素随氨基酸剂量增加而增加。与 NS 组相比,手术结束时 12-和 24-kJ 组游离脂肪酸明显降低。在氨基酸组中,负氮平衡在手术当天呈剂量依赖性缓解。在 24-kJ 组中,术后 24 小时内尿 3-甲基组氨酸明显减少,而在其他组中则增加,以 NS 组增加最多。在氨基酸组中,股外侧肌的基本、支链和芳香族氨基酸在手术结束时呈剂量依赖性增加。
术中氨基酸输注具有增加血糖、抑制脂肪动员和肌肉蛋白分解的剂量依赖性作用。