Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2010
Randomized Controlled Trial Comparative StudyProtein balance in nondiabetic versus diabetic patients undergoing colon surgery: effect of epidural analgesia and amino acids.
Surgical injury provokes a stress response that is thought to be pronounced in patients with diabetes mellitus type 2 (DM2) leading to intensified catabolism. The aim of this study was to compare the effects of perioperative epidural analgesia (EDA) versus patient controlled analgesia (PCA) and amino acid infusion on postoperative metabolism in patients with and without DM2. ⋯ A short-term infusion of amino acids reduced protein breakdown, increased protein synthesis, and rendered protein balance positive. This anabolic effect was pronounced in diabetic patients with EDA compared with nondiabetic patients or PCA, respectively, and prevented an undesirable hyperglycemia.