BACKGROUND: Recent studies reported that intraoperative
hyperglycemia is an independent
risk factor for mortality and
morbidity related to
surgery.
Volatile anesthetics, such as
sevoflurane, impair
glucose use, suggesting their possible contributions to intraoperative
hyperglycemia. However, the effects of IV
anesthetics, such as
propofol, on
glucose metabolism are poorly understood. Thus, we compared the effects of
sevoflurane and
propofol on
glucose metabolism under aerobic conditions in fed rats. METHODS: We first examined changes in
blood glucose levels in rats undergoing
sigmoid colostomy under
sevoflurane,
sevoflurane/
buprenorphine,
propofol, and
propofol/
buprenorphine anesthesia. We then examined changes in
blood glucose levels after
glucose administration using awake rats, rats under
sevoflurane anesthesia, and rats under
propofol anesthesia. RESULTS:
Blood glucose levels increased markedly after
sigmoid colostomy under
sevoflurane anesthesia; the marked increases could not be prevented by the coadministration of
buprenorphine. Under
propofol anesthesia,
blood glucose levels did not change after
sigmoid colostomy at the highest dose, but increased slightly at the lowest and intermediate doses; the slight increases were completely prevented by the coadministration of
buprenorphine. Whereas changes in
blood glucose levels after
glucose administration in rats under
sevoflurane anesthesia were significantly greater than those in awake rats, the changes in rats under
propofol anesthesia were similar to those in awake rats. CONCLUSIONS: During
surgery,
hyperglycemia was observed under
sevoflurane and
sevoflurane/
buprenorphine anesthesia, but
blood glucose levels were relatively stable under
propofol and
propofol/
buprenorphine anesthesia. Whereas
sevoflurane exaggerates
glucose intolerance,
propofol has no significant effects on
glucose tolerance. We speculate that this feature of
propofol contributes, at least in part, to the stable
glucose metabolism during
surgery observed in this study. The results of this study confirm the marked difference in the effects of
sevoflurane and
propofol on
glucose metabolism.
