Abstract
Hyperglycemia causes perioperative complications and many anesthetics impair glucose metabolism and cause hyperglycemia. We evaluated the effects of propofol on blood glucose metabolism and insulin secretion during an intravenous glucose tolerance test (IVGTT) in dogs. Blood glucose, insulin, triglyceride, cholesterol, and free fatty acid (FFA) levels were measured in dogs during IVGTT in a conscious state and under the effect of 2.0% isoflurane, low-concentration propofol (0.2 mg/kg/min), and high-concentration propofol (0.4 mg/kg/min) anesthesia. Plasma glucose levels significantly increased in all of the treatment groups when compared with those in the conscious group. The prolonged half-life period of plasma glucose suggested that isoflurane and propofol attenuated glucose metabolism in dogs. Plasma insulin levels were significantly lower in the isoflurane group when compared with those in the other groups, whereas blood FFA levels were increased in the propofol groups when compared with the other groups. These results suggest that propofol itself does not directly raise plasma glucose levels, but attenuates glucose metabolism by accumulating FFA.
Highlights
Several clinical studies have suggested that hyperglycemia increases the incidence of complications during the postoperative period in humans [1,2]
total intravenous anesthesia (TIVA) with propofol may induce hyperglycemia and increase the risk of perioperative complications in glucose metabolism-suppressed patients including those with diabetes
All dogs were assigned to four experimental groups by using a 4 × 7 Latin square design: conscious dogs subjected to the intravenous glucose tolerance test (IVGTT)
Summary
Several clinical studies have suggested that hyperglycemia increases the incidence of complications during the postoperative period in humans [1,2]. Some anesthetics are known to increase the incidence of hyperglycemia by suppressing glucose metabolism [3]. Propofol is one of these anesthetics and has been reported to suppress glucose metabolism in rats [4]. Propofol is a reliable and safe anesthetic agent. Propofol is used in various situations, including general anesthesia induction, total intravenous anesthesia (TIVA), and sedation in critical care units. Propofol is compatible with a large variety of pre-anesthetics that may increase its use as a safe and reliable intravenous anesthetic for the induction and maintenance of general anesthesia and sedation in small animal veterinary practice. TIVA with propofol may induce hyperglycemia and increase the risk of perioperative complications in glucose metabolism-suppressed patients including those with diabetes.
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