Endocrine, metabolic and cardiovascular responses to adrenaline after abdominal surgery

1990 ◽  
Vol 123 (2) ◽  
pp. 143-148 ◽  
Author(s):  
J. Hilsted ◽  
C. Wilken-Jensen ◽  
K. Birch ◽  
M. Damkjær Nielsen ◽  
J. J. Holst ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Abdominal Surgery ◽  
Cardiovascular Responses ◽  
Skin Incision ◽  
Plasma Adrenaline ◽  
Appearance Rate ◽  
Adrenaline Infusion ◽  
Plasma Camp ◽  
Β Receptor ◽  
Glucose Plasma

Abstract. Adrenaline-induced changes in heart rate, blood pressure, plasma adrenaline and noradrenaline, cortisol, glucagon, insulin, cAMP, glucose, lactate, glycerol and β-hydroxybutyrate were studied preoperatively and 4 and 24 h after skin incision in 8 patients undergoing elective cholecystectomy. Late postoperative responses of blood glucose, plasma cAMP, lactate and glycerol to adrenaline infusion were reduced, whereas other responses were unaffected. Blood glucose appearance and disappearance rate as assessed by [3H]3-glucose infusion was unchanged pre- and postoperatively. The increase in glucose appearance rate following adrenaline was similar pre- and postoperatively. These findings suggest that several β-receptor-mediated responses to adrenaline are reduced after abdominal surgery.

Altered platelet function during mental stress and adrenaline infusion in humans: evidence for an increased aggregability in vivo as measured by filtragometry

1989 ◽  
Vol 76 (4) ◽  
pp. 369-376 ◽  
Author(s):  
P. T. Larsson ◽  
P. Hjemdahl ◽  
G. Olsson ◽  
N. Egberg ◽  
G. Hornstra
Keyword(s):  
Platelet Function ◽  
Mental Stress ◽  
Cardiovascular Responses ◽  
Platelet Factor ◽  
Plasma Adrenaline ◽  
Platelet Aggregability ◽  
Coefficients Of Variation ◽  
Adrenaline Infusion ◽  
Placebo Infusion

1. The effects of mental stress induced by a colour word conflict test (CWT; n = 9) or 3 h infusions of placebo or adrenaline (0.4 nmol min−1 kg−1; n = 9) on platelet function in vivo were studied in 16 healthy male volunteers. 2. Platelet function was assessed by a filtragometry technique, which reflects aggregability in vivo, and by measurements of the plasma levels of β-thromboglobulin (β-TG) and platelet factor 4 (PF4). 3. Adrenaline and CWT induced marked cardiovascular responses as expected. Venous plasma adrenaline increased from 0.1–0.2 nmol/l at rest to 4.87 ± 0.42 nmol/l during adrenaline infusion and to 0.46 ± 0.10 nmol/l during CWT. 4. Filtragometry measurements were reproducible within individuals with coefficients of variation of 7.9% during placebo infusion and 5.4% for resting measurements between days. 5. Platelet aggregability, as measured by filtragometry, was similarly increased during both adrenaline infusion (P < 0.05) and CWT (P < 0.01). 6. The coefficients of variation for β-TG and PF4 levels were 17.3% for log β-TG and 27.9% for log PF4 between days, but could not be calculated for within-day variability. Both β-TG (P < 0.05) and PF4 (P < 0.01) levels decreased time-dependently during placebo infusion, indicating that long resting periods (hours) are needed to attain basal levels. Artefactual results could not be identified by evaluating βTG/PF4 ratios. 7. β-TG and PF4 levels did not decrease time-dependently during adrenaline infusion. There were no significant changes of β-TG or PF4 during CWT. 8. Our results suggest that platelet aggregability in vivo is enhanced by mental stress and high physiological levels of circulating adrenaline. The more pronounced effect of adrenaline and CWT on filtragometry readings than β-TG and PF4 levels in plasma suggests that platelet aggregability in vivo is not necessarily paralleled by increased platelet release.

Modeling the Effect of Blood Glucose and Physical Exercise on Plasma Adrenaline in People with Type 1 Diabetes

2007 ◽  
Vol 9 (6) ◽  
pp. 501-508 ◽  
Author(s):  
Jonas Kildegaard ◽  
Toke Folke Christensen ◽  
Mette Dencker Johansen ◽  
Jette Randløv ◽  
Ole K. Hejlesen
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Physical Exercise ◽  
Plasma Adrenaline

scholarly journals Effect of the artificial sweetener, sucralose, on gastric emptying and incretin hormone release in healthy subjects

2009 ◽  
Vol 296 (4) ◽  
pp. G735-G739 ◽  
Author(s):  
Jing Ma ◽  
Max Bellon ◽  
Judith M. Wishart ◽  
Richard Young ◽  
L. Ashley Blackshaw ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Gastric Emptying ◽  
Normal Saline ◽  
Sweet Taste ◽  
Artificial Sweetener ◽  
Healthy Humans ◽  
Sweet Taste Receptors ◽  
Glucagon Like Peptide 1 ◽  
Gip Release ◽  
Glucose Plasma

The incretin hormones, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), play an important role in glucose homeostasis in both health and diabetes. In mice, sucralose, an artificial sweetener, stimulates GLP-1 release via sweet taste receptors on enteroendocrine cells. We studied blood glucose, plasma levels of insulin, GLP-1, and GIP, and gastric emptying (by a breath test) in 7 healthy humans after intragastric infusions of 1) 50 g sucrose in water to a total volume of 500 ml (∼290 mosmol/l), 2) 80 mg sucralose in 500 ml normal saline (∼300 mosmol/l, 0.4 mM sucralose), 3) 800 mg sucralose in 500 ml normal saline (∼300 mosmol/l, 4 mM sucralose), and 4) 500 ml normal saline (∼300 mosmol/l), all labeled with 150 mg 13C-acetate. Blood glucose increased only in response to sucrose ( P < 0.05). GLP-1, GIP, and insulin also increased after sucrose ( P = 0.0001) but not after either load of sucralose or saline. Gastric emptying of sucrose was slower than that of saline ( t50: 87.4 ± 4.1 min vs. 74.7 ± 3.2 min, P < 0.005), whereas there were no differences in t50 between sucralose 0.4 mM (73.7 ± 3.1 min) or 4 mM (76.7 ± 3.1 min) and saline. We conclude that sucralose, delivered by intragastric infusion, does not stimulate insulin, GLP-1, or GIP release or slow gastric emptying in healthy humans.

scholarly journals Ultrasound-guided epidural anesthesia and sedation foropen abdominal surgery in 20 consecutive children:a prospective case series and proof-of-concept study

2020 ◽  
Author(s):  
Werner Schmid ◽  
Philipp Opfermann ◽  
Markus Zadrazil ◽  
Ursula Tonnhofer ◽  
Martin Metzelder ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Airway Management ◽  
Epidural Anesthesia ◽  
Recovery Room ◽  
Case Series ◽  
Skin Incision ◽  
Study Endpoint ◽  
Primary Study ◽  
Ultrasound Guided ◽  
Drug Induced

Abstract General anesthesia (GA) in children is associated with respiratory events and a potential for drug-induced neurotoxicity. Aiming to reduce airway manipulation and the use of GA drugs, we designed a study of abdominal surgery under epidural anesthesia in sedated, spontaneously breathing children. We enrolled 20 children (3 − 83 months, 6.3 − 25.0 kg) scheduled for open abdominal surgery with Pfannenstiel incision. Sedation was followed by ultrasound-guided epidural anesthesia. Increases in heart rate by > 15% and or patient movements upon skin incision were rated as block deficiencies. Intubation equipment for advanced airway management was kept on standby. The primary study endpoint was successful blockade, meaning that no sequential airway management was required during surgery. Secondary endpoints included any use of fentanyl/propofol intraoperatively and of postoperative analgesics in the recovery room. All 20 blocks were successful, with no block deficiencies upon skin incision, no need for sequential airway management, and stable SpO2 levels (97–100%). Surgery took a median of 120.5 minutes (IQR: 89.3–136.5) and included one bolus of fentanyl 120 minutes into a protracted operation. No more systemic analgesia had to be provided in the recovery room. Sedation and epidural anesthesia emerged as a useful alternative to GA from our consecutive case series.

scholarly journals The B2 Receptor of Bradykinin Is Not Essential for the Post-Exercise Increase in Glucose Uptake by Insulin-Stimulated Mouse Skeletal Muscle

2011 ◽  
pp. 511-519 ◽  
Author(s):  
G. G. SCHWEITZER ◽  
C. M. CASTORENA ◽  
T. HAMADA ◽  
K. FUNAI ◽  
E. B. ARIAS ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Blood Glucose ◽  
Glucose Uptake ◽  
Insulin Action ◽  
Plasma Insulin ◽  
Treadmill Exercise ◽  
Post Exercise ◽  
Skeletal Muscle Glucose Uptake ◽  
Glucose Plasma ◽  
Exercise Induced

Bradykinin can enhance skeletal muscle glucose uptake (GU), and exercise increases both bradykinin production and muscle insulin sensitivity, but bradykinin’s relationship with post-exercise insulin action is uncertain. Our primary aim was to determine if the B2 receptor of bradykinin (B2R) is essential for the post-exercise increase in GU by insulin-stimulated mouse soleus muscles. Wildtype (WT) and B2R knockout (B2RKO) mice were sedentary or performed 60 minutes of treadmill exercise. Isolated soleus muscles were incubated with [3H]-2-deoxyglucose ±insulin (60 or 100 μU/ml). GU tended to be greater for WT vs. B2RKO soleus with 60 μU/ml insulin (P=0.166) and was significantly greater for muscles with 100 μU/ml insulin (P<0.05). Both genotypes had significant exercise-induced reductions (P<0.05) in glycemia and insulinemia, and the decrements for glucose (~14 %) and insulin (~55 %) were similar between genotypes. GU tended to be greater for exercised vs. sedentary soleus with 60 μU/ml insulin (P=0.063) and was significantly greater for muscles with 100 μU/ml insulin (P<0.05). There were no significant interactions between genotype and exercise for blood glucose, plasma insulin or GU. These results indicate that the B2R is not essential for the exercise-induced decrements in blood glucose or plasma insulin or for the post-exercise increase in GU by insulin-stimulated mouse soleus muscle.

scholarly journals Comparison between scalpel incision and electrocautery incision in midline abdominal surgery: a comparative study

2021 ◽  
Vol 8 (5) ◽  
pp. 1507
Author(s):  
Amit Yadav ◽  
Lakshman Agarwal ◽  
Sumit A. Jain ◽  
Sanjay Kumawat ◽  
Sandeep Sharma
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Abdominal Surgery ◽  
Wound Infection ◽  
Skin Incision ◽  
P Value ◽  
Wound Area ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Fear of poor wound healing have curtailed the use of diathermy for making skin incision. Scalpel produces little damage to surrounding tissue but causing more blood loss. Our aim of study was to compare electrocautery incision with scalpel incision in terms of incision time, blood loss, postoperative pain and wound infection.Methods: Total of 104 patients were included in the study undergoing midline abdominal surgery. Patients were randomized into electrocautery (group A) and scalpel (group B). The incision dimension, incision time and blood loss were noted intraoperatively. Postoperative pain was noted on postoperative day 2 using visual analog scale. Wound complications were recorded on every postoperative day till the patient was discharged.Results: 52 patients in each of the two groups were analyzed. There was significant difference found between group A and group B in terms of mean incision time per unit wound area, 8.16±1.59 s\cm2 and 11.02±1.72 s\cm2 respectively (p value=0.0001). The mean blood loss per unit wound area was found to be significantly lower in group A (0.31±0.04 ml\cm2) as compared to group B (1.21±0.21), p value=0.0001. There was no significant difference noted in terms of postoperative pain and wound infection between both groups.Conclusions: Electrocautery can be considered safe in making skin incision in midline laparotomy compared to scalpel incision with comparable postoperative pain and wound infection with less intraoperative blood loss and less time consuming.

Remifentanil Requirements during Sevoflurane Administration to Block Somatic and Cardiovascular Responses to Skin Incision in Children and Adults

2002 ◽  
Vol 97 (5) ◽  
pp. 1142-1145 ◽  
Author(s):  
Hernán R. Muñoz ◽  
Luis I. Cortínez ◽  
Fernando R. Altermatt ◽  
Jorge A. Dagnino
Keyword(s):  
Infusion Rate ◽  
Cardiovascular Responses ◽  
Skin Incision ◽  
Autonomic Response ◽  
P Value ◽  
Anesthesia Induction ◽  
Remifentanil Infusion ◽  
Autonomic Responses ◽  
Unpaired Student ◽  
Somatic Response

Background The authors found no studies comparing intraoperative requirements of opioids between children and adults, so they determined the infusion rate of remifentanil to block somatic (IR50) and autonomic response (IRBAR50) to skin incision in children and adults. Methods Forty-one adults (aged 20-60 yr) and 24 children (aged 2-10 yr) undergoing lower abdominal surgery were studied. In adults, anesthesia induction was with sevoflurane during remifentanil infusion, whereas in children remifentanil administration was started after induction with sevoflurane. After intubation, sevoflurane was administered in 100% O2 and was adjusted to an ET% of 1 MAC-awake corrected for age at least 15 min before surgery. Patients were randomized to receive remifentanil at a rate ranging from 0.05 to 0.35 microg x kg(-1) x min(-1) for at least 20 min before surgery. At the beginning of surgery, only the skin incision was performed, and the somatic and autonomic responses were observed. The somatic response was defined as positive with any gross movement of extremity, and the autonomic response was deemed positive with any increase in heart rate mean arterial pressure equal to or more than 10% of preincision values. Using logistic regression, the IR50 and IRBAR50 were determined in both groups of patients and compared with unpaired Student t test. A P value less than 0.05 was considered significant. Results The IR50 +/- SD was 0.10 +/- 0.02 microg x kg(-1) x min(-1) in adults and 0.22 +/- 0.03 microg x kg(-1) x min(-1) in children (P &lt; 0.001). The IRBAR50 +/- SD was 0.11 +/- 0.02 microg x kg(-1) x min(-1) in adults and 0.27 +/- 0.06 microg x kg(-1) x min(-1) in children (P &lt; 0.001). Conclusions To block somatic and autonomic responses to surgery, children require a remifentanil infusion rate at least twofold higher than adults.

Central and peripheral adrenoceptors affect glucose, free fatty acids, and insulin in exercising rats

1988 ◽  
Vol 255 (4) ◽  
pp. R547-R556 ◽  
Author(s):  
A. J. Scheurink ◽  
A. B. Steffens ◽  
L. Benthem
Keyword(s):  
Fatty Acids ◽  
Blood Glucose ◽  
Free Fatty Acids ◽  
Blood Samples ◽  
Beta Adrenoceptor ◽  
Plasma Ffa ◽  
Glucose Plasma ◽  
Exercise Induced ◽  
Counter Current ◽  
Lateral Area

The effects of intravenously and intrahypothalamically administered alpha- and beta-adrenoceptor antagonists on exercise-induced alterations in blood glucose, plasma free fatty acids (FFA), and insulin were investigated in rats. Exercise consisted of strenuous swimming against a counter current for 15 min. Before, during, and after swimming, blood samples were withdrawn through a permanent heart catheter. Intravenous administration of the alpha-blocker phentolamine led to a reduction in glucose and a substantial increase in insulin levels. Infusion of phentolamine through permanent bilateral cannulas into either the ventromedial or lateral area of the hypothalamus (VMH and LHA, respectively) completely prevented the increase in glucose while the decline in insulin was unaffected. Infusion of phentolamine into the VMH caused much higher plasma FFA levels than in controls. The beta-blocker timolol given intravenously caused a delayed increase in glucose and prevented the increase in FFA. Infusion of timolol into either VMH or LHA caused a delay in the increase in both glucose and FFA. The results suggest that 1) both peripheral and hypothalamic adrenoceptors are involved in energy metabolism during exercise and 2) FFA, glucose, and insulin concentrations in blood are independently regulated by VMH and LHA.

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