PMID: 3767477Oct 1, 1986Paper

Hypothermic anesthesia attenuates postoperative proteolysis

Annals of Surgery
D J JohnsonD W Wilmore

Abstract

The catabolic response that commonly occurs after major operation is characterized by net skeletal muscle proteolysis and accelerated nitrogen excretion. This response was absent in patients undergoing cardiac surgical procedures associated with the combination of cardiopulmonary bypass, narcotic anesthesia, neuromuscular blockade, and hypothermia. Forearm nitrogen release was 422 +/- 492 nmol/100 ml X min on the first postoperative day, approximately 25% of preoperative values (1677 +/- 411, p less than 0.05). Nitrogen excretion and the degree of negative nitrogen balance were comparable to levels observed in nonstressed, fasting subjects. The potential role of hypothermia, high-dose fentanyl anesthesia, and neuromuscular blockade in modifying the catabolic response to laparotomy and retroperitoneal dissection was further evaluated in animal studies. Six hours after operation, amino acid nitrogen release from the hindquarter was 84% less than control values (p less than 0.05). Nitrogen excretion and urea production were also reduced compared to normothermic controls. It is concluded that the combination of hypothermia, narcotic anesthesia, and neuromuscular blockade attenuates the catabolic response to injury and thus may be u...Continue Reading

References

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Citations

Mar 1, 1995·British Heart Journal·I M MitchellM P Jamieson
Oct 4, 2011·Neurochemistry International·Javier Vaquero
Feb 1, 1991·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·K HersioK Huttunen
Jul 1, 1991·The Journal of Surgical Research·K HerskowitzW W Souba
Jul 1, 1995·The Journal of Thoracic and Cardiovascular Surgery·J GonzalezD Wilmore
Oct 26, 2005·Journal of Hepatology·Javier VaqueroRoger F Butterworth
Mar 1, 1996·Perfusion·I M MitchellR W Logan
Mar 1, 1989·Diabetes/metabolism Reviews·R R WolfeW H Hartl
Jan 1, 1991·The American Journal of Physiology·D P TaggartH J Burns
Mar 11, 2005·Journal of Clinical Gastroenterology·Javier Vaquero, Andres T Blei

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