Hepatic Gluconeogenesis During Halothane Anaesthesia in Man

It is known that hepatic gluconeogenesis from lactate and aminoacids is inhibited by halothane in in vitro studies on isolated, perfused livers. In the present work, the effect of halothane anaesthesia on hepatic gluconeogenesis was studied in three volunteers during a constant amino‐acid infusion and compared with three control subjects who did not receive any halothane during the amino‐acid infusion. Prior to the investigation, all the subjects were on a carbohydrate‐poor diet in order to deplete hepatic glucogen stores. During the investigation, hepatic gluconeogenesis was stimulated by a constant amino‐acid infusion which caused a slight rise in total hepatic blood flow (THBF), a marked increase in splanchnic oxygen consumption and oxygen extraction, elevation in blood glucose and urea levels and in splanchnic glucose and urea releases. Halothane anaesthesia administered during continued amino‐acid infusion caused a reduction in THBF to sub‐control values, while the increased oxygen consumption was only slightly reduced, thereby further increasing splanchnic oxygen extraction. Blood glucose and urea levels of the anaesthetized subjects were consistent with those of the control subjects. Splanchnic release of glucose was reduced almost to control values during halothane. However, the release of urea was only slightly reduced. It is concluded that the stimulating effect on hepatic gluconeogenesis caused by the amino‐acid infusion was inhibited during halothane anaesthesia, while metabolization of the amino‐acids, other than through gluconeogenesis, proceeded without any major changes.

[1]  L. Irestedt,et al.  The Different Responses of the Hepatic Arterial Bed to Hypovolaemia and to Halothane Anaesthesia , 1977, Acta anaesthesiologica Scandinavica.

[2]  K. Frayn,et al.  Rates of glucose utilization and glucogenesis in rats in the basal state induced by halothane anaesthesia. , 1977, The Biochemical journal.

[3]  L. Irestedt,et al.  The Effect of Controlled Halothane Anaesthesia on Splanchnic Oxygen Consumption in the Dog , 1975, Acta anaesthesiologica Scandinavica.

[4]  R. Gingerich,et al.  Inhibition by Ether of Glucose-stimulated Insulin Secretion in Isolated Pieces of Rat Pancreas , 1974, Anesthesiology.

[5]  J. Biebuyck,et al.  Effects of halothane and other anesthetic agents on the concentrations of rat liver metabolites in vivo. , 1974, Molecular pharmacology.

[6]  E. Hultman,et al.  Carbohydrate metabolism of the liver in normal man under varying dietary conditions. , 1973, Scandinavian journal of clinical and laboratory investigation.

[7]  E. Hultman,et al.  Liver glycogen in man--the effect of total starvation or a carbohydrate-poor diet followed by carbohydrate refeeding. , 1973, Scandinavian journal of clinical and laboratory investigation.

[8]  R. Clarke.  Anaesthesia and carbohydrate metabolism. , 1973, British journal of anaesthesia.

[9]  H. Krebs,et al.  The protective effect of oleate on metabolic changes produced by halothane in rat liver. , 1972, The Biochemical journal.

[10]  H. Krebs,et al.  The effects of halothane (2-bromo-2-chloro-1,1,1-trifluoroethane) on glycolysis and biosynthetic processes of the isolated perfused rat liver. , 1972, The Biochemical journal.

[11]  D. Schalch,et al.  Major Inhalation Anesthetics and Carbohydrate Metabolism , 1971, Anesthesia and analgesia.

[12]  E. Hultman,et al.  The effect of the administration of L-tryptophan on synthesis of urea and gluconeogenesis in man. , 1971, Scandinavian journal of clinical and laboratory investigation.

[13]  R. Harris,et al.  Action of halothane upon mitochondrial respiration. , 1971, Archives of biochemistry and biophysics.

[14]  R. Zollinger,et al.  The role of the liver in the development of lactic acidosis in low flow states , 1969, Postgraduate medical journal.

[15]  W. Howland,et al.  The Effect of Ether and Halothane on Blood Levels of Glucose, Pyruvate, Lactate and Metabolites of the Tricarboxylic Acid Cycle in Normotensive Patients During Operation , 1967, Anesthesiology.

[16]  N. M. Greene,et al.  Inhalation Anesthetics, Carbon Dioxide and Glucose Transport Across Red Cell Membranes , 1967, Acta anaesthesiologica Scandinavica.

[17]  M. Behar,et al.  Can General Anesthetics Produce Splanchnic Visceral Hypoxia by Reducing Regional Blood Flow? , 1966, Anesthesiology.

[18]  N. M. Greene.  Inhalation anesthetics and permeability of human erythrocytes to monosaccharides. , 1965, Anesthesiology.

[19]  J. D. Clark,et al.  EXCESS LACTATE PRODUCTION DURING HALOTHANE ANESTHESIA IN MAN. , 1964, JAMA.

[20]  H. Krebs.  The Croonian Lecture, 1963 Gluconeogenesis , 1964, Proceedings of the Royal Society of London. Series B. Biological Sciences.

[21]  A. L. Chaney,et al.  Modified reagents for determination of urea and ammonia. , 1962, Clinical chemistry.

[22]  S. Patrick,et al.  Halothane and carbohydrate metabolism , 1959, Anaesthesia.

[23]  E. Hultman.  Rapid Specific Method for Determination of Aldosaccharides in Body Fluids , 1959, Nature.

[24]  R. Virtue,et al.  Observations during experimental and clinical use of fluothane. , 1958, Anesthesiology.

[25]  Myers Jd.  The effects of the intravenous administration of glucose and amino acids on the hepatic blood flow and splanchnic oxygen consumption of man. , 1948 .

[26]  J. J. Curry,et al.  THE ESTIMATION OF HEPATIC BLOOD FLOW IN MAN. , 1945, The Journal of clinical investigation.

[27]  J. Kinney,et al.  The demands of hyperalimentation on splanchnic blood flow and oxygen consumption. , 1974, Surgical forum.

[28]  R. Gingerich,et al.  Inhibition by halothane of glucose-stimulated insulin secretion in isolated pieces of rat pancreas. , 1974, Anesthesiology.

[29]  R. Miller,et al.  The effect of halothane on electron transport, oxidative phosphorylation, and swelling in rat liver mitochondria. , 1970, Molecular pharmacology.

[30]  Hunter Fe,et al.  The effect of halothane on electron transport, oxidative phosphorylation, and swelling in rat liver mitochondria. , 1970 .

[31]  P. Felig,et al.  Role of substrate in the regulation of hepatic gluconeogenesis in fasting man. , 1969, Advances in enzyme regulation.

[32]  E. Hultman.  Blood circulation in the liver under physiological and pathological conditions. , 1966, Scandinavian journal of clinical and laboratory investigation. Supplementum.

[33]  J. D. Myers.  The effects of the intravenous administration of glucose and amino acids on the hepatic blood flow and splanchnic oxygen consumption of man. , 1948, Federation proceedings.