The effects of intraoperative glucose infusion on portal blood insulin concentration and hepatic mitochondrial redox state during surgery: Comparisonof short-term and continuous infusions

The relationships between the blood glucose level, portal blood immunoreact ive insulin (IRI) concentration, ketogenesis, and hepatic mitochondrial red ox state associated with intraoperative glucose administration were evaluat ed in patients undergoing total gastrectomy. A total of 26 patients were ra ndomly allocated to two groups according to the type of infusion given; gro up 1 was given a short-term glucose infusion of 25 g in 30 min and group 2 was given a continuous glucose infusion of 10 g/h, The blood glucose concen tration peaked 30 min after the goucose infusion was commenced, then decrea sed in group 1, despite a continuous rise in group 2. A temporary but signi ficantly higher blood glucose level was observed in group 1 than in group 2 , 30 and 60 min after the infusion was commenced. The portal blood IRI conc entrations and arterial ketone body ratio (AKBR) continued to increase and the blood ketone body concentrations continued to decline after the start o f the glucose infusion in both groups; however, after 60 and 120 min, the p ortal blood IRI and AKBR levels were significantly higher, and the blood ke tone body levels significantly lower in group 1 than in group 2, These find ings suggest that intraoperative glucose administration is beneficial for i nsulin secretion, ketogenesis, and the hepatic mitochondrial redox state, a nd that short-term infusion is superior to continuous infusion.