PMID- 18165568
OWN - NLM
STAT- MEDLINE
DCOM- 20081022
LR  - 20131121
IS  - 1526-7598 (Electronic)
IS  - 0003-2999 (Linking)
VI  - 106
IP  - 1
DP  - 2008 Jan
TI  - Anesthesia's effects on plasma glucose and insulin and cardiac hexokinase at 
      similar hemodynamics and without major surgical stress in fed rats.
PG  - 135-42, table of contents
LID - 10.1213/01.ane.0000297299.91527.74 [doi]
AB  - BACKGROUND: Recent evidence suggests that hexokinase mitochondria association 
      attenuates cell death, and that plasma glucose and insulin concentrations can 
      influence clinical outcome. In the present study, we examined how different 
      anesthetics per se affect these variables of glucose metabolism, i.e., under 
      similar hemodynamic conditions and in the absence of major surgical stress. 
      METHODS: In fed rats, the effects of pentobarbital (PENTO), isoflurane (ISO), 
      sevoflurane (SEVO), ketamine-medetomidine-atropine (KMA), and 
      sufentanil-propofol-morphine (SPM) on the cardiac cellular localization of 
      hexokinase (HK) and levels of plasma glucose and insulin were determined and 
      compared with values obtained in nonanesthetized animals (control). The role of 
      mitochondrial and sarcolemmal K(ATP)-channels and alpha2-adrenergic receptor in 
      ISO-induced hyperglycemia was also evaluated. RESULTS: Mean arterial blood 
      pressure was similar among the different anesthetic strategies. PENTO (5.3 +/- 
      0.2 mM) and SPM (5.1 +/- 0.2 mM) had no significant effect on plasma glucose when 
      compared with control (5.6 +/- 0.1 mM). All other anesthetics induced 
      hyperglycemia: 7.4 +/- 0.2 mM (SEVO), 9.9 +/- 0.3 mM (ISO), and 14.8 +/- 1.0 mM 
      (KMA). Insulin concentrations were increased with PENTO (2.13 +/- 0.13 ng/mL) 
      when compared with control (0.59 +/- 0.22 ng/mL), but were unaffected by the 
      other anesthetics. Inhibition of the mitochondrial K(ATP) channel 
      (5-hydroxydecanoate acid) or the alpha(2)-adrenergic receptor (yohimbine) did not 
      prevent ISO-induced hyperglycemia. Only the nonspecific K(ATP) channel inhibitor 
      glibenclamide was able to prevent hyperglycemia by ISO. Cytoslic HK relative to 
      total HK increased in the following sequence: control (35.5% +/- 2.1%), SEVO 
      (35.5% +/- 2.7%), ISO (36.6% +/- 1.7%), PENTO (41.2% +/- 2.0%; P = 0.082 versus 
      control), SPM (43.0% +/- 1.8%; P = 0.039 versus control), and KMA (46.6 +/- 2.3%; 
      P = 0.002 versus control). CONCLUSIONS: Volatile anesthetics and KMA induce 
      hyperglycemia, which can be explained, at least partly, by impaired 
      glucose-induced insulin release. The data indicate that the inhibition of insulin 
      release by ISO is mediated by sarcolemmal K(ATP) channel activation. The use of 
      PENTO and SPM is not associated with hyperglycemia. SPM and KMA reduce the 
      antiapoptotic association of HK with mitochondria.
FAU - Zuurbier, Coert J
AU  - Zuurbier CJ
AD  - Department of Anaesthesiology, Academic Medical Centre, University of Amsterdam, 
      Amsterdam, The Netherlands. c.j.zuurbier@amc.uva.nl
FAU - Keijzers, Peter J M
AU  - Keijzers PJ
FAU - Koeman, Anneke
AU  - Koeman A
FAU - Van Wezel, Harry B
AU  - Van Wezel HB
FAU - Hollmann, Markus W
AU  - Hollmann MW
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Anesth Analg
JT  - Anesthesia and analgesia
JID - 1310650
RN  - 0 (Adrenergic alpha-Antagonists)
RN  - 0 (Anesthetics)
RN  - 0 (Blood Glucose)
RN  - 0 (Decanoic Acids)
RN  - 0 (Hydroxy Acids)
RN  - 0 (Insulin)
RN  - 0 (Potassium Channel Blockers)
RN  - 0 (Potassium Channels)
RN  - 0 (Receptors, Adrenergic, alpha-2)
RN  - 0 (mitochondrial K(ATP) channel)
RN  - 2Y49VWD90Q (Yohimbine)
RN  - 624-00-0 (5-hydroxydecanoic acid)
RN  - EC 2.7.1.1 (Hexokinase)
RN  - SX6K58TVWC (Glyburide)
SB  - IM
MH  - Adrenergic alpha-Antagonists/pharmacology
MH  - Anesthetics/*adverse effects
MH  - Animals
MH  - Blood Glucose/*drug effects
MH  - Body Weight/drug effects
MH  - Cytosol/enzymology
MH  - Decanoic Acids/pharmacology
MH  - Glyburide/pharmacology
MH  - Hemodynamics/drug effects
MH  - Hexokinase/*metabolism
MH  - Hydroxy Acids/pharmacology
MH  - Hyperglycemia/blood/*chemically induced/enzymology
MH  - Insulin/*blood
MH  - Male
MH  - Mitochondria, Heart/*drug effects/enzymology
MH  - Myocardium/*enzymology
MH  - Postprandial Period
MH  - Potassium Channel Blockers/pharmacology
MH  - Potassium Channels/drug effects/metabolism
MH  - Rats
MH  - Rats, Wistar
MH  - Receptors, Adrenergic, alpha-2/drug effects/metabolism
MH  - Sarcolemma/drug effects/metabolism
MH  - Yohimbine/pharmacology
EDAT- 2008/01/01 09:00
MHDA- 2008/10/23 09:00
CRDT- 2008/01/01 09:00
PHST- 2008/01/01 09:00 [pubmed]
PHST- 2008/10/23 09:00 [medline]
PHST- 2008/01/01 09:00 [entrez]
AID - 106/1/135 [pii]
AID - 10.1213/01.ane.0000297299.91527.74 [doi]
PST - ppublish
SO  - Anesth Analg. 2008 Jan;106(1):135-42, table of contents. doi: 
      10.1213/01.ane.0000297299.91527.74.