Effects of thoracic epidural analgesia on glucose homeostasis after cardiac surgery in patients with and without diabetes mellitus

European Journal of Anaesthesiology

Volumn 22, Issue 7, 2005, Pages 524-529

  Anderson, Russell E ^a   Ehrenberg, J ^a   Barr, G ^a   Brismar, K ^a   Owall A ^a   Alserius, T ^a   Ivert, T ^a  

^a KAROLINSKA UNIVERSITY HOSPITAL   (Sweden)

Author keywords

Anaesthesia epidural, thoracic; Anaesthesia general; Blood glucose; Diabetes mellitus; Thoracic surgery, cardiovascular

Indexed keywords

BUPIVACAINE; FENTANYL; GLUCOSE; INSULIN; LIDOCAINE; MIDAZOLAM; MORPHINE; NEUTRAL INSULIN; PROPOFOL; RINGER ACETATE;

ADULT; AGED; ANGINA PECTORIS; ARTICLE; CLINICAL ARTICLE; CONTROLLED STUDY; DIABETES MELLITUS; EPIDURAL ANESTHESIA; GLUCOSE HOMEOSTASIS; HEART SURGERY; HUMAN; HYPERGLYCEMIA; POSTOPERATIVE PERIOD;

AGED; ANALGESIA, EPIDURAL; BLOOD GLUCOSE; CARDIAC SURGICAL PROCEDURES; CORONARY ARTERY BYPASS; DIABETES MELLITUS, TYPE 2; FEMALE; HEMOGLOBIN A, GLYCOSYLATED; HUMANS; HYPOGLYCEMIC AGENTS; INSULIN; MALE; MIDDLE AGED; POSTOPERATIVE CARE; PROSPECTIVE STUDIES;

EID: 22244485687     PISSN: 02650215     EISSN: None     Source Type: Journal    
DOI: 10.1017/S0265021505000906     Document Type: Article

References (20)

1. van den Berghe G, Wouters P, Weekers F et al. Intensive insulin therapy in the critically ill patients. New Engl J Med 2001; 345: 1359-1367.
2. Muhlestein JB, Anderson JI, Horne BD et al. Effect of fasting glucose levels on mortality rate in patients with and without diabetes mellitus and coronary artery disease undergoing percutaneous coronary intervention. Am Heart J 2003; 146: 351-358.
3. Norhammar AM, Rydén L, Malmberg K. Admission plasma glucose: independent risk factor for long-term prognosis after myocardial infarction even in non-diabetic patients. Diab Care 1999; 22: 1827-1831.
4. Alvarez-Sabin J, Molina CA, Montaner J et al. Effects of admission hyperglycaemia on stroke outcome in reperfused tissue plasminogen activator-treated patients. Stroke 2003; 34: 1235-1241.
5. Krinsley JS. Effect of an intensive glucose management protocol on the mortality of critically ill adult patients. Mayo Clin Proc 2004; 79: 992-1000.
6. Mesotten D, Delhanty JD, Vanderhoydonc F et al. Intensive insulin therapy in the critically ill patients. J Clin Endocrin Metab 2003; 87: 5516-5523.
7. Furnary AP, Gao G, Grunkemeier GL et al. Continuous insulin infusion reduces mortality in patients with diabetes undergoing coronary artery bypass grafting. J Thor Cardiovasc Surg 2003; 125: 1007-1021.
8. Thorell A, Efendic S, Gutniak M, Haggmark T, Ljungqvist O. Insulin resistance after abdominal surgery. Br J Surg 1994; 81: 59-63.
9. Thorell A, Nygren J, Ljungqvist O. Insulin resistance: a marker of surgical stress. Curr Opin Clin Nutr Metab Care 1999; 2: 69-78.
10. Carvalho G, Moore A, Qizilbash B, Lachapelle K, Schricker T. Maintenance of normoglycemia during cardiac surgery. Anesth Analg 2004; 99: 319-324.
11. Moore CM, Cross MH, Descorough JP et al. Hormonal effects of thoracic extradural analgesia for cardiac surgery. Br J Anaesth 1995; 75: 387-393.
12. Stenseth R, Bjella L, Berg EM, Christensen O, Levang OW, Gisvold SE. Thoracic epidural analgesia in aortocoronary bypass surgery. II: Efects on the endocrine metabolic response. Acta Anaesth Scand 1994; 38: 834-839.
13. Richardson J, Sabanathan S, Jones J, Shah RD, Cheema S, Mearns AJ. A preospective, randomized comparison of preoperative and continuous balanced epidural or paravertabral bupivacaine on post-thoractomy pain, pulmonary function and stress responses. Br J Anaesth 1999; 83: 387-392.
14. Latterman R, Carli F, Wykes L et al. Epidural blockade modifies perioperative glucose production without affecting protein catabolism. Anesthesiology 2002; 97: 374-381.
15. Uchida I, Asoh T, Shirasaka C, Tsuji H. Effect of epidural analgesia on postoperative insulin resistance as evaluated by insulin clamp technique. Br J Surg 1988; 75: 557-562.
16. Roth-Isigkeit A, Dibbelt L, Eichler W, Schumacher J, Schmucker P. Blood levels of atrial natriuretic peptide, endothelin, cortisol and ACTH in patients undergoing coronary artery bypass grafting surgery with cardiopulmonary bypass. J Endocrin Invest 2001; 24: 777-785.
17. Werb MR, Zinman B, Teasdale SJ, Goldman BS, Scully HE, Marliss EB. Hormonal and metabolic responses during coronary artery bypass surgery: role of infused glucose. J Clin Endocrin Metab 1989; 69: 1010-1018.
18. Bromage PR, Shibata HR, Willoughby HW. Influence of prolonged epidural blockade on blood sugar and cortisol responses to operations on the upper part of the abdomen and thorax Surgery. Gynecol Obstet 1971; 132: 1051-1056.
19. Loick HM, Schmidt C, Van Aken H et al. Thigh thoracic epidural anesthesia, but not clonidine attenuates the perioperative stress response via sympatholysis and reduces the release of tropinin T in patients undergoing coronary artery bypass grafting. Anesth Analg 1999; 88: 701-709.
20. Liem TH, Booij LH, Gielen MJ, Hasenbos MA, van Egmond J. Coronary artery bypass grafting using two different anesthetic techniques. Part 3: Adrenergic responses. J Thor Cardiovasc Anesth 1992; 6: 162-167.