Skip to main content
Log in

The changes in arterial keton bodies during upper abdominal surgery

  • Original Articles
  • Published:
Journal of Anesthesia Aims and scope Submit manuscript

Abstract

The relationship between the arterial keton body ratio (AKBR: acetoacetate/β-hydroxybutyrate) and the plasma hormone activities were studied under a general anesthesia using enfl.urane group (group G) and a GO + Epidural group (group E) with continuous glucose loading (10g·hr−1) during partial gastrectomy. In both groups, the AKBR increased significantly during the operation. The plasma insulin activity was significantly positively correlated with the AKBR and it was negatively correlated with log (β-hydroxybutyrate) in both groups. We could not find any significant difference of the AKBR between group G and group E. Our results indicate that the plasma insulin activity affects the arterial keton body ratio and that the AKBR must be evaluated considering the plasma hormone activity, especially insulin activity during the operation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Shimahara Y, Ozawa K, Ida T, Ukikusa M, Tobe T: Role of mitochondria enhancement in maintaining hepatic energy charge level in endotoxin shock. Journal of Surgical Research 33:314–323, 1982

    Article  CAS  PubMed  Google Scholar 

  2. Asano M, Jikko A, Yamato T, Ukikusa M, Kimura K, Kamiyama K, Ozawa K, TobeT: Sequential changes in blood concentrations of fuels in relation to arterial blood keton body ratio after 70% hepatectomy in rabbits. Res Exp Med 185:253–258, 1985

    Article  CAS  Google Scholar 

  3. Ozawa K, Aoyama H, Yasuda K, Shimahara Y, Nakatani T, Tanaka J, Yamamoto M, Kamiyama Y, Tobe T: Metabolic abnormalities associated with postoperative organ failure. A redox Theory. Arch Surg 118:1245–1251, 1983

    CAS  PubMed  Google Scholar 

  4. Harano Y, Shigeta Y: Ketsueki, Nyoketontai. Rinshoi 9;114, 1986

    Google Scholar 

  5. Keller U, Chiasson JL, Liljenquist JE, Cherrington AD, Jennings AS, Crofford OB: The roles of insulin, glucagon and free fatty acids in the regulation of ketogenesis in dogs. Diabetes 26:1040–1051, 1977

    CAS  PubMed  Google Scholar 

  6. McGarry JD, Foster DW: Regulation of hepatic fatty acid oxidation and keton body production. Ann Rev Biochem 49:395–420, 1980

    Article  CAS  PubMed  Google Scholar 

  7. Hakanson E, Rutberg J, Jorfeldt L, Martensson J: Effects of the extradural administration of morphin or bupivacaine, on the metabolic response to upper abdominal. Br J Anaesth 57:394–399, 1985

    Article  CAS  PubMed  Google Scholar 

  8. Imagawa K, Nishino T, Shin S, Uehata S, Harashima E, Yanaihara E, Yanaihara C, Tanaihara N: Production of antiglucagon sera with AC-terminal fragment of pancreatic glucagon. Endocrinol. Japon 26:123–131, 1979

    CAS  Google Scholar 

  9. Shimizu S, Tani Y, Yamada H, Tabata M, Murachi T: Enzymatic determination of serum free fatty acids: A colorimetric method. Analytical Biochemistry 107:193–198, 1980

    Article  CAS  PubMed  Google Scholar 

  10. Harano Y, Kosugi K, Hyosu T, Uno S, Ishikawa Y, Shigeta Y: Sensitive and simplified method for the differential determina, tion of serum levels of keton bodies. Clinica Chimica Acta 134:327–336, 1983

    Article  CAS  Google Scholar 

  11. Williamson DH, Lund P, Krebs HA: The redox state of free nicotiamide-adenine dinucleotide in the cytoplasma and mitochondria of rat liver. Biochem J 103:514–527, 1967

    CAS  PubMed  Google Scholar 

  12. Asano M, Ozawa K, Tobe T: Postoperative prognosis as related to blood keton body ratio in hepatectomized patients. Eur Surg Res 15:302–311, 1983

    Article  CAS  PubMed  Google Scholar 

  13. Mils JM, Gerich JE: Glucose and keton body kinetics in diabetic ketoacidosis. Clinics in Endocrinology and Metabolism 12:303–319, 1983

    Article  Google Scholar 

  14. Miles JM, Rizza RA, Haymond MW, Gerich JE: Effects of acute insulin deficiency on glucose and keton body turnover in man. Diabetes 29:926–930, 1980

    CAS  PubMed  Google Scholar 

  15. Brandt M, Kehlet H, Binder C Hagen C Mcneilly AS: Effects of epidural analgesia on the glycoregulatory endocrine response to surgery. J Clin Endocrinol 5:107–114, 1976

    CAS  Google Scholar 

  16. Sherwin RS, Hendler RG, Felig P: Effects of diabetes mellitus and insulin on the turnover and metabolic response to ketones in man. Diabetes 25:776–784, 1976

    Article  CAS  PubMed  Google Scholar 

  17. Balasse EO, Havel RJ: Evidence for an effects of insulin on the peripheral utilization of keton bodies in dogs. J Clin Invest 50:801–813, 1971

    Article  CAS  PubMed  Google Scholar 

  18. Stanley JC: The glucose-fatty acid-keton body cycle. Role of keton bodies as respiratory substrate and metabolic signals. Br J Anaesth 53:131–136, 1981

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

About this article

Cite this article

Ogata, M., Obata, K., Matsumoto, T. et al. The changes in arterial keton bodies during upper abdominal surgery. J Anesth 4, 131–137 (1990). https://doi.org/10.1007/s0054000040131

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s0054000040131

Key words

Navigation