Differences between the Effects of Sevoflurane and Propofol Anesthesia on Insulin Sensitivity in Fasted Rats Undergoing Descending Colostomy

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type:TOHO University Scholarly Publication

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Introduction: Glucose metabolism is modified perioperatively, resulting in hyperglycemia. While surgical stress is the predominant factor for hyperglycemic responses, anesthesia also modifies glucose metabolism. We examined the effects of anesthetics on intraoperative insulin sensitivity in fasted rats. Methods: Two experiments were carried out in this study. In experiment 1, fasted rats underwent descending colostomy under sevoflurane (n = 8) and propofol (n = 8) anesthesia without exogenous glucose administration. The surgery took approximately 30 min. Blood glucose, plasma insulin, tumor necrosis factor-α, and high-molecular-weight adiponectin levels were measured. Before and after surgery, insulin sensitivity was evaluated using the quantitative insulin sensitivity check index (QUICKI) in each rat. In experiment 2, fasted rats underwent descending colostomy under sevoflurane (n = 8) and propofol (n = 8) anesthesia with exogenous glucose administration. Subsequently, these rats underwent the insulin tolerance test (ITT); we measured blood glucose levels 30 min after insulin administration. Results: In experiment 1, rats under propofol anesthesia showed significantly lower blood glucose levels and significantly higher plasma insulin levels than rats under sevoflurane anesthesia before and after surgery. Rats under propofol anesthesia had a significantly lower QUICKI than rats under sevoflurane anesthesia. In experiment 2, rats under propofol anesthesia had less decreases in blood glucose levels during ITT than rats under sevoflurane anesthesia. Additionally, plasma tumor necrosis factor-α (TNF-α) levels under propofol anesthesia were significantly higher than those under sevoflurane anesthesia. Conclusions: Propofol anesthesia impairs insulin sensitivity during surgery in fasted rats, compared with sevoflurane anesthesia; TNF-α might be involved in insulin resistance.

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