Postoperative Nitrogen Excretion After Amino Acid-Induced Thermogenesis Under Anesthesia
Postoperative Nitrogen Excretion After Amino Acid-Induced Thermogenesis Under Anesthesia
复制标题
麻醉下氨基酸诱导生热后的术后氮排泄
作者：
E. Selldén;S. Lindahl
全麻期间氨基酸输注可诱导生热，防止术后体温过低。麻醉期间产热增加对术后氮平衡的影响尚未被研究。因此，我们研究了24例子宫切除术患者围术期氨基酸输注对术后氮排泄的影响。7名未接受麻醉或手术的志愿者作为清醒对照。异氟醚麻醉期间，8例患者在麻醉前和麻醉中给予醋酸化林格氏液，16例患者在麻醉中给予240 kJ/h的氨基酸混合液静脉注射。测量直肠温度和能量消耗。术前1天及术后4天用尿素、肌酐、尿酸计算尿氮含量。记录饮食。在麻醉对照患者中，术后氮排泄低于术前水平。这些患者在麻醉期间也经历了最大的核心体温下降（1.7 +/- 0.1[度标志]C）。所有患者术后都有颤抖。氨基酸组麻醉时体温下降不明显（1.0 +/- 0.1[度征象]C； P < 0.001），术后寒战消失。此外，术后氮排泄没有变化，这可能表明已知产生热量的蛋白质周转增加。综上所述，氨基酸引起的产热增加减少了低温，消除了寒战，并减弱/正常化了未接受氨基酸治疗的患者术后的氮保存。意义：我们比较了异氟醚麻醉下接受生理盐水或氨基酸输注的患者手术前后的氮排泄情况。氨基酸引起的产热增加减少了低温，消除了寒战，并减弱/正常化了未接受氨基酸的患者术后的氮保存。（Anesth Analg 1998;87:641-6）
Amino acid infusions during general anesthesia induce thermogenesis and prevent postoperative hypothermia.The effects of increased heat production during anesthesia on postoperative nitrogen balance have not been examined. Therefore, we studied the effect of perioperative amino acid infusions on postoperative nitrogen excretion in 24 patients scheduled for hysterectomy. Seven volunteers not subjected to anesthesia or surgery were used as awake controls. During isoflurane anesthesia, 8 patients received acetated Ringer's solution, and 16 patients received an IV amino acid mixture, 240 kJ/h, before and during anesthesia. Rectal temperature and energy expenditure were measured. The urinary nitrogen content was calculated from urea, creatinine, and urate the day before surgery and for 4 days postoperatively. Diets were recorded. In anesthetized control patients, postoperative nitrogen excretion was less than preoperative levels. Those patients also experienced the largest decrease in core body temperature during anesthesia (1.7 +/- 0.1[degree sign]C). All had postoperative shivering. In the amino acid-treated patients, the temperature decrease during anesthesia was less pronounced (1.0 +/- 0.1[degree sign]C; P < 0.001) and postoperative shivering disappeared. In addition, the nitrogen excretion was unchanged postoperatively, perhaps indicating an increase in protein turnover known to generate heat. In conclusion, the increase in heat production induced by amino acids reduced hypothermia, abolished shivering, and attenuated/normalized the postoperative nitrogen saving that occurred in patients who did not receive amino acids. Implications: We compared nitrogen excretion before and after surgery in patients who received a saline or amino acid infusion during isoflurane anesthesia. The increase in heat production induced by amino acids reduced hypothermia, abolished shivering, and attenuated/normalized the postoperative nitrogen saving that occurred in patients who did not receive amino acids. (Anesth Analg 1998;87:641-6)
影响因子：
158.5
作者：
Kurz, A;Sessler, DI;Lenhardt, R
通讯作者：
Lenhardt, R