Laparoscopic-assisted vaginal hysterectomy and the hyperglycemic response to surgery: an observational study

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
Ralph LattermannM Schreiber

Abstract

To test the hypothesis that laparoscopic-assisted vaginal hysterectomy (LAVH) attenuates the hyperglycemic response to surgery when compared to vaginal hysterectomy (VH). Fourteen patients received either LAVH (n=7) or VH (n=7). Whole body glucose production was measured before and three hours after surgery using [6.6-2H2] glucose. Before, during and after the operation, plasma concentrations of glucose, insulin, glucagon, cortisol, epinephrine and norepinephrine were determined. Plasma glucose concentration increased in both groups during and after surgery showing a significantly higher value after VH than after LAVH (VH: 8.3 +/- 1.4 mmol x L(-1); LAVH: 6.6 +/- 0.9 mmol x L(-1), P <0.05). The postoperative increase in glucose production was comparable in both groups. While plasma concentrations of insulin and glucagon remained unchanged, intra- and postoperative plasma cortisol concentrations were significantly higher in the VH group than in the LAVH group. Plasma catecholamine concentrations significantly increased after both types of surgery to the same extent. In this observational study, LAVH appears to blunt the hyperglycemic and cortisol response to surgery when compared to VH.

References

Jan 1, 1991·Archives of Gynecology and Obstetrics·G GitschG Tatra
Aug 1, 1990·Anesthesiology·C Weissman
Sep 1, 1990·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·T TsuboT Oyama
Mar 1, 1973·British Journal of Anaesthesia·I D Johnston
Feb 1, 1981·British Journal of Anaesthesia·C Traynor, G M Hall
Jan 1, 1994·The British Journal of Surgery·M S JakewaysF Carli
Oct 1, 1996·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·H IwasakaN Honda
May 8, 1999·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·T SchrickerM Georgieff

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Citations

Jan 24, 2007·Anesthesiology Clinics·Aviv Tuttnauer, Phillip D Levin

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