The study of blood glucose level changes during general anesthesia in patients undergoing surgery

Background: Analgesia is meant to reduce the pain produced by surgery. To fulfil this requirement various drugs such as alcohol, opium, hashish and balladona have been used in the past by the Egyptians and Chinese for the control of pain during surgery when the anesthesia was not known. Glucose is a carbohydrate required for energy. During the process of metabolism of glucose the source storage come into play. Nervous influence, enzymatic action and hormonal involvement also have a significant role. Aim: The aim of the study was the study of blood glucose level changes during general anesthesia in patients under surgery. Materials and methods: The present study was done in the department of Anesthesiology during the year 2015-2016, 60 patients with age group of 25-65 years along with different sex distribution. Results: Regarding the anaesthesia group, there were 15 patients in the age group of 25-35 years and 36-45 years each.14 patients were in age group 46-55 years, while 16 patients in the age group of 56- G.V. Krishna Reddy, M. Madan Mohan Rao, G obulesu, R Salma Mahaboob. The study of blood glucose level changes during general anesthesia in patients undergoing surgery. IAIM, 2017; 4(1): 110-115. Page 111 65 years. Out of 60 patients 33 patients (55%) were male patients while remaining 27 patients (45%) were female patients. Conclusion: Present study showed that there is very highly significant rise in blood glucose level during the ether anesthesia while in case of relaxants there is only significant rise in blood glucose level.

Suppression by gallamine triethiodide on the increased afferent discharge from the muscle spindle caused by succinylcholine / 西安交通大学学报(医学版)

Objective To study the effect of gallamine triethiodide (GT) on the increased afferent discharge from the muscle spindle caused by succinylcholine (SCh). Methods The nervous filaments of rats were separated from tibial nerve innervating the gastrocnemius muscle, and afferent discharge from the muscle spindle was recorded. SCh of a certain dose was injected after 4 minutes of injection of a certain dose of GT. The effect of suppression by GT on the increased afferent discharge from the muscle spindle caused by SCh was measured by counting the decrease in discharge peak frequency (DPF) and maximum increase frequency (MIF) and by counting the time of peak frequency (PF) appearing delayed than the controls. Results When the dose of SCh was 0.005mmol/kg, the dose of GT was 0.005mmol/kg, 0.010mmol/kg and 0.020mmol/kg, DPF reduced to 67.2%, 52.5% and 37.1% of the controls, respectively; MIF reduced to 61.4%, 40.2.% and 25.4%; PF appearing time delayed 43.9s, 64.3s and 80.4s than the controls. When the dose of GT was 0.005mmol/kg but the dose of SCh was 0.010mmol/kg, DPF and MIF reduced to 83.3% and 77.8% of the controls, respectively; PF appearing time delayed 22.5s than the controls. Conclusion GT has a remarkably suppressive effect on the increase in afferent discharge from the muscle spindle induced by SCh. The suppression of GT is dose-dependent, and the action of SCh and GT on muscle spindle is in competition.

Effects of Gallamine, Vecuronium and Rocuronium on Oculocardiac Reflex, Blood Pressure and Heart Rate in Pediatric Strabismus Surgery / 대한마취과학회지

BACKGROUND: Intraoperative oculocardiac reflex (OCR) is a common problem of pediatric strabismus surgery and potentially fatal as it can cause cardiac arrest. The goal of this study was to assess the effects of gallamine, vecuronium and rocuronium on the oculocardiac reflex, blood pressure and heart rate in pediatric strabismus surgery. METHODS: Ninety healthy children undergoing strabismus surgery were randomly assigned to three groups; gallamine, vecuronium or rocuronium group. All children were under general anesthesia induced with thiopental sodium and received gallamine 3 mg/kg, vecuronium 0.1 mg/kg, or rocuronium 0.8 mg/kg as a muscle relaxant, and were maintained with sevoflurane in 50% nitrous oxide. Systolic blood pressure, diastolic blood pressure, and heart rate were measured before anesthesia, before the operation, before traction and after traction of the ocular muscle. The OCR was defined as a 20% or greater decrease in heart rate from before traction of the ocular muscle. RESULTS: Compared with three groups, there were decreased incidences of OCR and increased heart rate at before the operation, before traction and after traction in the gallamine group (P<0.05). Systolic blood pressure and diastolic blood pressure were no differences occurred among three groups. CONCLUSIONS: We found that the gallamine group results in decreased incidences of OCR and increased heart rate were comparable with three groups.

Inhibitory Effects of Structurally Different Neuromuscular Blockers on the Serotonin Type 3 Receptor Expressed in Xenopus Oocytes / 대한마취과학회지

BACKGROUND: The serotonin type 3 receptors are diffusely distributed in both the central and the peripheral nervous system. Physiological and pathophysiological processes thought to be mediated by this receptor include nausea and vomiting, peripheral nociception and central antinociception, conditioned aversion response to drugs, anxiety, and cognition. Because of the structural similarity between the nicotinic acetylcholine receptor and the 5HT3 receptor, we investigated the effects of clinically used neuromuscular blockers on the 5HT3 receptor function related with PONV. METHODS: A cDNA clone encoding the full length murine 5HT3a receptor was subcloned into an oocyte expression vector and 50 ng of cRNA transcribed in vitro injected per oocyte. After 24 72 h incubation, oocytes were placed into a recording chamber continuously perfused with frog Ringer's solution and electrophysiological recordings were obtained by the two electrode voltage clamp technique. Serotonin with or without the various drugs were bath applied by a computer controlled solenoid valve. Peak currents induced by the drug applications were measured and dose responses were obtained. RESULTS: The 5HT3 receptor expression in Xenopus oocyte was identified by the pharmacologic tools. Serotonin induced rapid inward currents, and thus was showed dose-dependent: KD = 2.5 micrometer, Hill coefficiency = 2.09. Inhibition by the neuromuscular blockers showed dose-dependence and their inhibitory potency on 5HT3 receptor (IC50) was in order of d-tubocurarine (0.046 micrometer) > vecuronium (16.32 micrometer) > gallamine (1,169 micrometer). CONCLUSIONS: There was a different inhibitory effect of nicotinic cholinergic antagonists, clinically used neuromuscular blockers, on the 5HT3 receptor and a judicious selection of them might contribute to reducing the incidence of PONV clinically.

Inhibitory Effects of Structurally Different Neuromuscular Blockers on the Serotonin Type 3 Receptor Expressed in Xenopus Oocytes / 대한마취과학회지

BACKGROUND: The serotonin type 3 receptors are diffusely distributed in both the central and the peripheral nervous system. Physiological and pathophysiological processes thought to be mediated by this receptor include nausea and vomiting, peripheral nociception and central antinociception, conditioned aversion response to drugs, anxiety, and cognition. Because of the structural similarity between the nicotinic acetylcholine receptor and the 5HT3 receptor, we investigated the effects of clinically used neuromuscular blockers on the 5HT3 receptor function related with PONV. METHODS: A cDNA clone encoding the full length murine 5HT3a receptor was subcloned into an oocyte expression vector and 50 ng of cRNA transcribed in vitro injected per oocyte. After 24 72 h incubation, oocytes were placed into a recording chamber continuously perfused with frog Ringer's solution and electrophysiological recordings were obtained by the two electrode voltage clamp technique. Serotonin with or without the various drugs were bath applied by a computer controlled solenoid valve. Peak currents induced by the drug applications were measured and dose responses were obtained. RESULTS: The 5HT3 receptor expression in Xenopus oocyte was identified by the pharmacologic tools. Serotonin induced rapid inward currents, and thus was showed dose-dependent: KD = 2.5 micrometer, Hill coefficiency = 2.09. Inhibition by the neuromuscular blockers showed dose-dependence and their inhibitory potency on 5HT3 receptor (IC50) was in order of d-tubocurarine (0.046 micrometer) > vecuronium (16.32 micrometer) > gallamine (1,169 micrometer). CONCLUSIONS: There was a different inhibitory effect of nicotinic cholinergic antagonists, clinically used neuromuscular blockers, on the 5HT3 receptor and a judicious selection of them might contribute to reducing the incidence of PONV clinically.