LOW-DOSE INSULIN INFUSION AND SUBSTRATE MOBILIZATION DURING SURGERY

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Abstract
The effects of the i.v. infusion of insulin, 70 mu.kg−1h−1 for the first 60 min and 35 mu.kg−1h−1 subsequently, on the metabolic and endocrine responses to gynaecological surgery were investigated. In comparison with a control group of patients, the insulin infusion caused a marked decrease in circulating glucose, non-esterified fatty acids and β-hydroxybutyrate concentrations, and an increase in blood lactate values. The plasma cortisol response to surgery was unaffected by the decrease in blood glucose, but the growth hormone response was increased. Heart rates and arterial pressures during surgery were not altered by the metabolic changes associated with insulin infusion, but there was a greater decrease in aural temperature. The results demonstrate the importance of insulin suppression during surgery in mediating changes in circulating metabolites.