Int J Med Sci 2013; 10(9):1099-1107. doi:10.7150/ijms.5924 This issue Cite

Research Paper

The Effect of Intraoperative Use of High-Dose Remifentanil on Postoperative Insulin Resistance and Muscle Protein Catabolism: A Randomized Controlled Study

Hideki Taniguchi1,2,✉, Toshio Sasaki2, Hisae Fujita2, Osami Takano2, Tsutomu Hayashi3, Haruhiko Cho3, Takaki Yoshikawa3, Akira Tsuburaya3

1. School of Nutrition & Dietetics, Kanagawa University of Human Services, Kanagawa, Japan;
2. Department of Anesthesiology, Kanagawa Cancer Center, Kanagawa, Japan;
3. Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Kanagawa, Japan.

Citation:
Taniguchi H, Sasaki T, Fujita H, Takano O, Hayashi T, Cho H, Yoshikawa T, Tsuburaya A. The Effect of Intraoperative Use of High-Dose Remifentanil on Postoperative Insulin Resistance and Muscle Protein Catabolism: A Randomized Controlled Study. Int J Med Sci 2013; 10(9):1099-1107. doi:10.7150/ijms.5924. https://www.medsci.org/v10p1099.htm
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Abstract

Objective: We investigated the effect of the intraoperative use of a high dose remifentanil on insulin resistance and muscle protein catabolism.

Design: Randomized controlled study.

Patients and Intervention: Thirty-seven patients undergoing elective gastrectomy were randomly assigned to 2 groups that received remifentanil at infusion rates of 0.1 μg·kg-1·min-1 (Group L) and 0.5 μg·kg-1·min-1 (Group H).

Main outcome measures: Primary efficacy parameters were changes in homeostasis model assessment as an index of insulin resistance (HOMA-IR) and 3-methylhistidine/creatinine (3-MH/Cr). HOMA-IR was used to evaluate insulin resistance, and 3-MH/Cr was used to evaluate the progress of muscle protein catabolism. Intraoperative stress hormones, insulin, and blood glucose were assessed as secondary endpoints.

Results: Eighteen patients in Group L and 19 in Group H were examined. HOMA-IR values varied within normal limits in both groups during surgery, exceeding normal limits at 12 h after surgery and being significantly elevated in Group L. There were no significant differences in the 3-MH/Cr values between the 2 groups at any time point. The stress hormones (adrenocorticotropic hormone, cortisol, and adrenaline) were significantly elevated in Group L at 60 min after the start of surgery and at the initiation of skin closure. There were no significant differences in insulin values, but blood glucose was significantly elevated in Group L at 60 min after the start of surgery and at the start of skin closure.

Conclusion: Use of high-dose remifentanil as intraoperative analgesia during elective gastrectomy reduced postoperative insulin resistance, although it did not reduce postoperative muscle protein catabolism.

Keywords: remifentanil, insulin resistance, muscle protein catabolism.


Citation styles

APA
Taniguchi, H., Sasaki, T., Fujita, H., Takano, O., Hayashi, T., Cho, H., Yoshikawa, T., Tsuburaya, A. (2013). The Effect of Intraoperative Use of High-Dose Remifentanil on Postoperative Insulin Resistance and Muscle Protein Catabolism: A Randomized Controlled Study. International Journal of Medical Sciences, 10(9), 1099-1107. https://doi.org/10.7150/ijms.5924.

ACS
Taniguchi, H.; Sasaki, T.; Fujita, H.; Takano, O.; Hayashi, T.; Cho, H.; Yoshikawa, T.; Tsuburaya, A. The Effect of Intraoperative Use of High-Dose Remifentanil on Postoperative Insulin Resistance and Muscle Protein Catabolism: A Randomized Controlled Study. Int. J. Med. Sci. 2013, 10 (9), 1099-1107. DOI: 10.7150/ijms.5924.

NLM
Taniguchi H, Sasaki T, Fujita H, Takano O, Hayashi T, Cho H, Yoshikawa T, Tsuburaya A. The Effect of Intraoperative Use of High-Dose Remifentanil on Postoperative Insulin Resistance and Muscle Protein Catabolism: A Randomized Controlled Study. Int J Med Sci 2013; 10(9):1099-1107. doi:10.7150/ijms.5924. https://www.medsci.org/v10p1099.htm

CSE
Taniguchi H, Sasaki T, Fujita H, Takano O, Hayashi T, Cho H, Yoshikawa T, Tsuburaya A. 2013. The Effect of Intraoperative Use of High-Dose Remifentanil on Postoperative Insulin Resistance and Muscle Protein Catabolism: A Randomized Controlled Study. Int J Med Sci. 10(9):1099-1107.

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