EFFECTS OF GENERAL ANESTHESIA ON PERIPHERAL BLOOD LEVELS OF CARBOHYDRATE AND FAT METABOLITES AND SERUM INORGANIC PHOSPHORUS

¹ Anesthesia Laboratory of the Harvard Medical School at the Massachusetts General Hospital, Boston, Massachusetts

Peripheral venous and arterial blood concentrations of glucose, pyruvate, lactate, citrate, alpha-ketoglutarate, total ketones and serum inorganic phosphorus were measured during uncomplicated clinical anesthesia in man with diethyl-ether, cyclopropane, and thiopental under conditions of fasting and administered glucose. Measurements of total fatty acids, phospholipids, cholesterol and cholesterol esters were also made during ether anesthesia under fasting conditions. No significant lipemia occurred during anesthesia with any agent. The observed changes in levels of glucose, organic acids, and ketones during ether and cyclopropane anesthesia were comparable to those observed following administered epinephrine or norepinephrine in the nonanesthetized patient and may therefore reflect the reflex release of norepinephrine during anesthesia with these agents. Elevations in serum inorganic phosphorus may have been secondary in part to depression of renal phosphorus excretion and to alterations in acid-base balance. However, the decreased glucose tolerance and absence of the expected decrease in serum inorganic phosphorus following administered glucose with all three anesthetics suggest the possibility of a defect in glucose transport or in phosphorylating mechanisms.