Abstract
Ketosis is one of problems due to preoperative starvation. The levels of blood glucose, blood ketone body, plasma free fatty acids (NEFA) and urine ketone body were measured in 69 children aged from 8 months to 11 years before and after glucose infusion. Blood glucose levels before infusion in the afternoon groups, whose operation started at 13:00, tended to be lower than that of in morning groups, whose operation started at 9:00. In the afternoon groups, levels of blood ketone body and plasma NEFA were significantly higher than those of the morning groups.
Hypoglycemia was found in one child, and blood glucose level before infusion in 3 afternoon cases were below 50 mg/dl with ketosis. Blood glucose levels after infusion were below 70mg/dl. In 4 afternoon cases the urine ketone body was detectable. The levels of blood ketone body and plasma NEFA was decreased by glucose infusion. There were no correlation between duration of starvation and blood glucose levels, but there was a positive significant correlation between blood ketone body levels and plasma NEFA. There were negative correlation between blood ketone body levels and ages, or body weights.
These findings suggested that preoperative starvation induced lipolysis particularly in afternoon cases, and preoperative levels of blood glucose and ketone body were affected by the time of operation, age, and body weight rather than the duration of starvation. Therefore we would consider the infusion rate of glucose with findings of this study.
