Department of Anesthesiology, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, China.
Department of Anesthesiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China.
BMC Anesthesiol. 2019 May 15;19(1):77. doi: 10.1186/s12871-019-0748-0.
Preoperative oral carbohydrates has been suggested to attenuate insulin resistance and decrease postoperative complications. In this study, a vitamin-rich carbohydrate beverage was administered before surgery in an animal model to investigate its effects on the surgical stress response and S-100β levels.
Thirty aged male Sprague-Dawley rats were randomly assigned to three groups: control group (n = 6), fasting group (n = 12), and carbohydrate-treated group (CHO group, n = 12). Rats in the control group were not given any treatment. Rats in the fasting group received splenectomy after 12 h of fasting. In the CHO group, rats were given 5 ml of vitamin-rich carbohydrate by gavage 2 h before surgery. Fasting plasma glucose, insulin, insulin resistance (HOMA-IR index, IRI), the S-100β protein level, and the inflammatory mediators IL-1β, IL-6 and TNF-α were assessed after surgery (postoperative day (POD) 1 and 3).
Postoperative insulin resistance was significantly greater in the fasting group than in the control and CHO group. The median plasma S-100β level was significantly higher in the fasting group than in the control and CHO groups on POD 1. The median plasma IL-1β level was significantly lower in the CHO group than in the fasting group on POD 1; however, no other differences in the concentrations of immunological biomarkers of stress were found between the fasting group and the CHO group.
Vitamin-rich carbohydrate pretreatment attenuated the metabolic aspect of the surgical stress response and decreased the level of plasma S-100β, which may decrease the risk of postoperative complications in elderly rats.
术前口服碳水化合物已被证明可以减轻胰岛素抵抗并减少术后并发症。在这项研究中,我们在动物模型中给予富含维生素的碳水化合物饮料,以研究其对手术应激反应和 S-100β 水平的影响。
30 只老年雄性 Sprague-Dawley 大鼠随机分为三组:对照组(n = 6)、禁食组(n = 12)和碳水化合物处理组(CHO 组,n = 12)。对照组大鼠未给予任何治疗。禁食组大鼠在禁食 12 小时后接受脾切除术。在 CHO 组,大鼠在手术前 2 小时通过灌胃给予 5ml 富含维生素的碳水化合物。在手术后(术后第 1 天和第 3 天)评估禁食血浆葡萄糖、胰岛素、胰岛素抵抗(HOMA-IR 指数、IRI)、S-100β 蛋白水平以及炎症介质 IL-1β、IL-6 和 TNF-α。
与对照组和 CHO 组相比,禁食组术后胰岛素抵抗明显更大。与对照组和 CHO 组相比,禁食组术后第 1 天的血浆 S-100β 水平中位数明显更高。与禁食组相比,CHO 组术后第 1 天的血浆 IL-1β 水平中位数明显更低;然而,在应激免疫生物标志物浓度方面,禁食组和 CHO 组之间没有发现其他差异。
富含维生素的碳水化合物预处理可减轻手术应激反应的代谢方面,并降低血浆 S-100β 水平,这可能降低老年大鼠术后并发症的风险。