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Metabolic Effects of Anesthetics

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Modern Inhalation Anesthetics

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Abstract

The metabolic responses to general anesthesia are the result of many simultaneous and interrelated biochemical reactions. Some are caused by the anesthetic acting directly on cell metabolism. Others are secondary to anesthetically induced changes in, for example, blood gas tensions, organ blood flows, and neuro-endocrine function. Clear differentiation between direct and indirect effects is often difficult. The metabolic alterations concerned, be they direct or indirect, are manifestations of abnormal function and as such they are basic to a full understanding of the anesthetic state. Unfortunately, our present understanding of the metabolic effects of anesthesia is incomplete. In part this is due to limitations inherent in the present state of the art and science of human biochemistry. In part it is due to limitations resulting from the fact that until very recently few modern biochemical research technics have been applied to the field of anesthesia. Enough information is, however, available on the metabolic effects of anesthetics to warrant review at this time. Since all compounds capable of depressing neuronal function do not have metabolic effects in common, the present review is restricted to the effects of inhalation anesthetics, old and new, with the separate field of the metabolic effects of nonvolatile “anesthetics” omitted. Emphasis is placed on data which have become available since the subject was reviewed in 1963 (Green 1963).

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References

  • Albers, C., Brendel, W., Usinger, W.: Kreislauf respiratorischer Stoffwechsel und Atmung in Athernarkose. Arch. exp. Pathol. Pharmakol., Naunyn-Schmiedeberg’s 226, 278 (1955).

    CAS  Google Scholar 

  • Alexander, S. C., Cohen, P. J., Wollman, H., Smith, T. C., Reivich, M., Molen, R. A. U.: Cerebral carbohydrate metabolism during hypocarbia in man. Studies during nitrous oxide anesthesia. Anesthesiology 26, 624 (1965).

    Article  PubMed  CAS  Google Scholar 

  • Andersen, N. B.: Effect of general anesthetics on sodium transport in the isolated toad bladder. Anesthesiology 27, 304 (1966).

    PubMed  CAS  Google Scholar 

  • Andersen, N. B.: Synergistic effect of cyclopropane and epinephrine on sodium transport in toad bladder. Anesthesiology 28, 438 (1967).

    Article  PubMed  CAS  Google Scholar 

  • Annamunthodo, H., Keating, V., Patrick, S. J.: Liver glycogen alteration in anaesthesia and surgery. Anaesthesia 13, 429 (1958).

    Article  PubMed  CAS  Google Scholar 

  • Aprahamian, H. A., Vanderveen, J. L., Bunker, J. P., Murphy, A. J., Crawford, J. D.: The influence of general anesthetics on water and solute excretion in man. Ann. Surg. 150, 122 (1959).

    Article  PubMed  CAS  Google Scholar 

  • Banerji, H., Reid, C.: The adrenals and anesthetic hyperglycemia. J. Physiol. (London) 78, 370 (1933).

    CAS  Google Scholar 

  • Bass, W. P., Watts, D. T., Chase, H. F.: Ether hyperglycemia as influenced by premedication and Pentothal induction. Anesthesiology 14, 18 (1953).

    Article  PubMed  CAS  Google Scholar 

  • Beecher, H. K., Francis, L., Anfinsen, C. B.: Metabolic effects of anesthesia in man. I. Acid-base balance during ether anesthesia. J. Pharmacol, exptl Therap. 98, 38 (1950).

    CAS  Google Scholar 

  • Bergman, N. A.: Components of the alveolar-arterial oxygen tension difference in anesthetized man. Anesthesiology 28, 517 (1967).

    PubMed  CAS  Google Scholar 

  • Brewster, W. R., Jr., Bunker, J. P., Beecher, H. K.: Metabolic effects of anesthesia: mechanism of metabolic acidosis and hyperglycemia during ether anesthesia in the dog. Amer. J. Physiol. 171, 37 (1952).

    PubMed  CAS  Google Scholar 

  • Bunker, J. P.: Metabolic effects of blood transfusion. Anesthesiology 27, 446 (1966).

    Article  PubMed  CAS  Google Scholar 

  • Bunker, J. P., Beecher, H. K., Briggs, B. D., Brewster, W. R., Jr., Barnes, B. A.: Metabolic effects of anesthesia. II. A comparison of the acid-base equilibrium in man and dogs during ether and cyclopropane anesthesia. J. Pharmacol. Exptl Therap. 102, 62 (1951).

    CAS  Google Scholar 

  • Bunker, J. P.: Brewster, W. R., Jr., Smith, R. M., Beecher, H. K.: Metabolic effects of anesthesia in man: acid-base balance in infants and children during anesthesia. J. Appl. Physiol. 5, 233 (1952).

    PubMed  CAS  Google Scholar 

  • Burnap, T. K., Galla, S. J., Vandam, L. D.: Anesthetic, circulatory and respiratory effects of Fluothane. Anesthesiology 19, 307 (1958).

    Article  PubMed  CAS  Google Scholar 

  • Cervenko, F. W., Greene, N. M.: Effect of cyclopropane anesthesia on glucose assimilation coefficient in man. Anesthesiology 28, 914 (1967).

    Article  PubMed  CAS  Google Scholar 

  • Christian, G., Greene, N. M.: Blood carbonic anhydrase activity in anesthetized man. Anesthesiology 23, 179 (1962).

    Article  PubMed  CAS  Google Scholar 

  • Cohen, P. J., Marshall, B. E.: Effects of halothane on respiratory control and oxygen consumption of rat liver mitochondria. In: Toxicity of anesthetics ( Fink, B. R., Ed.). Baltimore: The Williams & Wilkins Co. 1968.

    Google Scholar 

  • Cohen, P. J., Wollman, H., Alexander, S. C., Chase, P. E., Behar, M. G.: Cerebral carbohydrate metabolism in man during halothane anesthesia: Effects of PaCO2 on some aspects of carbohydrate utilization. Anesthesiology 25, 185 (1964).

    Article  PubMed  CAS  Google Scholar 

  • Cooperman, L. H., Warden, J. C., Price, H. L.: Splanchnic circulation during nitrous oxide anesthesia and hypocarbia in normal man. Anesthesiology 29, 254 (1968).

    Article  PubMed  CAS  Google Scholar 

  • Deutsch, S., Linde, H. W., Price, H. L.: Circulatory and sympathoadrenal responses to cyclopropane in the dog. J. Pharmacol. Exptl Therap. 135, 354 (1962).

    CAS  Google Scholar 

  • Deutsch, S., Pierce, E. C., Jr., Vandam, L. D.: Cyclopropane effects on renal function in normal man. Anesthesiology 28, 547 (1967).

    PubMed  CAS  Google Scholar 

  • Dobkin, A. B.: Effect of Fluothane on acid-base balance. Anesthesiology 20, 10 (1959).

    Article  PubMed  CAS  Google Scholar 

  • Dobkin, A. B., Byles, P. H., Neville, J. F., Jr.: Neuroendocrine and metabolic effects of general anaesthesia and graded haemorrhage. Canad. Anaesth. Soc. J. 13, 453 (1966).

    Article  PubMed  CAS  Google Scholar 

  • Dobkin, A. B., Fedortjk, S.: A comparison of the cardiovascular, respiratory and metabolic effects of methoxyflurane and halothane in dogs. Anesthesiology 22, 355 (1961).

    Article  PubMed  CAS  Google Scholar 

  • Dobkin, A. B., Harland, J. H., Fedortjk, S.: Trichlorethylene and halothane in a precision system: Comparison of cardiorespiratory and metabolic effects in dogs. Anesthesiology 23, 58

    Google Scholar 

  • Drucker, W. R., Costley, C., Stults, R., Holden, W. D., Craig, J., Miller, M., Hoffman, N., Woodward, H.: Studies of carbohydrate metabolism during ether anesthesia: effect of ether on glucose and fructose metabolism. Metabolism 8, 828 (1959).

    Google Scholar 

  • Drucker, W. R., Costley, C., Stults, R., Miller, M., Craig, J. W., Woodward, H.: The effect of ether anesthesia on pyruvate metabolism. Surg. Forum 7, 185 (1957).

    PubMed  CAS  Google Scholar 

  • Drucker, W. R., Davis, H. S., Burget, D., Powers, A. L., Sieverding, E.: Effect of halothane and cyclopropane anesthesia on energy metabolism in hypovolemic animals. J. Trauma 5, 503 (1965).

    Article  PubMed  CAS  Google Scholar 

  • Epstein, R. M., Deutsch, S., Cooperman, L. H., Clement, A. J., Price, H. L.: Splanchnic circulation during halothane anesthesia and hypercapnia in man. Anesthesiology 27, 654 (1966).

    Article  PubMed  CAS  Google Scholar 

  • Epstein, R. M., Wheeler, H. D., Frumin, M. J., Habif, D. V., Papper, E. M., Bradley, S. E.: The effect of hypercapnia on estimated hepatic sulfobromophthalein clearance during general anesthesia in man. J. Clin. Invest. 40, 592 (1961).

    Article  PubMed  CAS  Google Scholar 

  • Fink, B. R., Kenny, G. E.: Metabolic effects of volatile anesthetics in cell culture. Anesthesiology 29, 505 (1968).

    Article  PubMed  CAS  Google Scholar 

  • Galla, S. J.: Glucose pool size, turnover rate and C14O2 production during halothane anesthesia in dogs. Anesthesiology 28, 251 (1967).

    Article  Google Scholar 

  • Galla, S. J., Henneman, D. H., Schweizer, H. J., Yandam, L. D.: Effects of ether anesthesia on myocardial metabolism in dogs. Am. J. Physiol. 202, 241 (1962).

    PubMed  CAS  Google Scholar 

  • Galla, S. J., Wilson, E. P.: Hexose metabolism during halothane anesthesia in dogs. Anesthesiology 25, 96 (1964).

    Article  Google Scholar 

  • Gottlieb, S. F., Savran, S. U.: Nitrous oxide inhibition of sodium transport. Anesthesiology 28, 324 (1967).

    Article  PubMed  CAS  Google Scholar 

  • Greene, N. M.: (1) Lactate, pyruvate, and excess lactate production in anesthetized man. Anesthesiology 22, 404 (1961).

    Article  PubMed  CAS  Google Scholar 

  • Greene, N. M.: (2) Effect of epinephrine on lactate, pyruvate, and excess lactate production in normal human subjects. J. Lab. Clin. Med. 58, 682 (1961).

    PubMed  CAS  Google Scholar 

  • Greene, N. M.: Inhalation anesthetics and carbohydrate metabolism. Baltimore: Williams and Wilkins Co. 1963.

    Google Scholar 

  • Greene, N. M.: (1) Glucose permeability of human erythrocytes and the effects of inhalation anesthetics, oxygen, and carbon dioxide. Yale J. Biol, and Med. 37, 319 (1965).

    CAS  Google Scholar 

  • Greene, N. M.: (2) Inhalation anesthetics and permeability of human erythrocytes to monosaccharides. Anesthesiology 26, 731 (1965).

    Article  PubMed  CAS  Google Scholar 

  • Greene, N. M.: Cervenko, F. W.: Inhalation anesthetics, carbon dioxide, and glucose transport across red cell membranes. Acta Anaesth. Scand. Suppl. 28, (1967).

    Google Scholar 

  • Greene, N. M., Davis, M. T., Bell, J. K. S.: Effects of general anesthetics on tissue oxygen tension in man: skin. Anesthesiology 20, 830 (1959).

    Article  Google Scholar 

  • Greene, N. M., Goldenberg, I. S.: The effect of anesthesia on thyroid activity in humans. Anesthesiology 20, 125 (1959).

    Article  Google Scholar 

  • Greene, N. M.: Phillips, A. D’e.: Metabolic response of dogs to hypoxia in the absence of circulating epinephrine and norepinephrine. Am. J. Physiol. 189, 475 (1957).

    PubMed  CAS  Google Scholar 

  • Greene, N. M., Spencer, E. L., Jr.: Diethyl ether and lactate dehydrogenase activity in vitro. Anesthesiology 24, 23 (1963).

    Article  PubMed  CAS  Google Scholar 

  • Greene, N. M., Talner, N. S.: Blood lactate, pyruvate and lactate-pyruvate ratios in congenital heart disease. New Engl. J. Med. 270, 1331 (1964).

    Article  PubMed  CAS  Google Scholar 

  • Greene, N. M., Willenkin, R. L.: Skeletal muscle oxygen tension and metabolism during hemorrhagic hypotension and subsequent vasopressor administration. Yale J. Biol, and Med. 35, 429 (1963).

    CAS  Google Scholar 

  • Greifenstein, F. E.: Excess lactate during halothane-oxygen and halothane-nitrous oxide- oxygen anesthesia. Anesthesia & Analgesia 45, 362 (1966).

    Article  CAS  Google Scholar 

  • Habif, D. V., Papper, E. M., Fitzpatrick, H. F., Lowrance, P., Smythe, C. McC., Bradley, S. E.: The renal and hepatic blood flow, glomerular filtration rate, and urinary output of electrolytes during cyclopropane, ether, and thiopental anesthesia, operation, and the immediate postoperative period. Surgery 30, 241 (1951).

    PubMed  CAS  Google Scholar 

  • Hammond, W. G., Vandam, L. D., Davis, J. M., Carter, R. D., Ball, M. R., Moore, F. D.: Studies in surgical endocrinology: IV. Anesthetic agents as stimuli to change in corticosteroids and metabolism. Ann. Surg. 148, 199 (1958).

    Article  PubMed  CAS  Google Scholar 

  • Havel, R. J.: The autonomic nervous system and intermediary carbohydrate and fat metabolism. Anesthesiology 29, 702 (1968).

    Article  PubMed  CAS  Google Scholar 

  • Haworth, J., Duff, A.: A note on trichlorethylene anaesthesia. Brit. Med. J. 1943 I, 381.

    Article  Google Scholar 

  • Henneman, D. H., Bunker, J. P.: Pattern of intermediary carbohydrate metabolism in Cushing’s syndrome. Am. J. Med. 23, 34 (1957).

    Article  PubMed  CAS  Google Scholar 

  • Henneman, D. H., Bunker, J. P.: Effects of general anesthesia on peripheral blood levels of carbohydrate and fat metabolites and serum inorganic phosphorus. J. Pharmacol. Exptl Therap. 183, 253 (1961).

    Google Scholar 

  • Henneman, D. H., Vandam, L. D.: Effect of epinephrine, insulin, and tolbutamide on carbohydrate metabolism during ether anesthesia. Clin. Pharmacol. Ther. 1, 694 (1960).

    PubMed  CAS  Google Scholar 

  • Hewer, C. L., Hadfield, C. F.: Trichlorethylene as an inhalation anaesthetic. Brit. Med. J. 1941 I 924.

    Article  Google Scholar 

  • Hoech, G. P., Jr., Matteo, R. S., Fink, B. R.: Effect of halothane on oxygen consumption of rat brain, liver and heart and anaerobic glycolysis of rat brain. Anesthesiology 27, 770 (1966).

    Article  PubMed  CAS  Google Scholar 

  • Hunter, A. R.: Halothane and blood sugar. Brit. J. Anaesthesia 31, 490 (1959).

    CAS  Google Scholar 

  • Johnson, S. R.: Mechanisms of hyperglycamia during anesthesia: Experimental study. Anesthesiology 10, 379 (1949).

    Article  PubMed  CAS  Google Scholar 

  • Keating, V., Patrick, S. J., Annamunthodo, H.: Halothane and carbohydrate metabolism. Anaesthesia 14, 268 (1959).

    Article  PubMed  CAS  Google Scholar 

  • Levy, M. L., Palazzi, H. M., Nardi, G. L.,Bunker, J. P.: Hepatic blood flow variations during surgical anesthesia in man measured by radioactive colloid. Surg. Gynecol. Obstet. 112, 289 (1961).

    PubMed  CAS  Google Scholar 

  • Lowenstein, E., Clark, J. D., Villareal, Y.: Excess lactate production during halothane anesthesia in man. J. Am. Med. Assoc. 190, 1110 (1964).

    CAS  Google Scholar 

  • McDowall, D. G., Harper, A. M., Jacobson, I.: Cerebral blood flow during halothane anaesthesia. Brit. J. Anaesthesia 35, 394 (1963).

    Article  CAS  Google Scholar 

  • Nishioka, K., Levy, A. A., Dobkin, A. B.: Effect of halothane and methoxyflurane anaesthesia on plasma Cortisol concentration in relation to major surgery. Canad. Anaesth. Soc. J. 15, 441 (1968).

    Article  PubMed  CAS  Google Scholar 

  • Nowill, W. K., Stephen, C. R., Searles, P. W.: Evaluation of trichloroethylene as an anesthetic and analgesic agent. Arch. Surg. 66, 35 (1953).

    CAS  Google Scholar 

  • Nunn, J. F., Matthews, R. L.: Gaseous exchange during halothane anaesthesia: The steady respiratory state. Brit. J. Anaesthesia 31, 330 (1959).

    Article  CAS  Google Scholar 

  • Oyama, T., Saito, T., Isomatsu, T., Samejima, N., Uemura, T., Arimura, A.: Plasma levels of ACTH and Cortisol in man during diethyl ether anesthesia and surgery. Anesthesiology 29, 559 (1968).

    Article  PubMed  CAS  Google Scholar 

  • Price, H. L., Deutsch, S., Cooperman, L. H., Clement, A. J., Epstein, R. M.: Splanchnic circulation during cyclopropane anesthesia in normal man. Anesthesiology 26, 312 (1965).

    Article  PubMed  CAS  Google Scholar 

  • Price, H. L., Deutsch, S., Davidson, I. A., Clement, A. J., Behar, M. G., Epstein, R. M.: Can general an-esthetics produce splnachnic visceral hypoxia by reducing regional blood flow ? Anesthe-siology 27, 24 (1966).

    Article  CAS  Google Scholar 

  • Price, H. L., Linde, H. W., Jones, R. E., Black, G. W., Price, M. L.: Sympathoadrenal responses to general anesthesia in man and their relation to hemodynamics. Anesthesiology 20, 563 (1959).

    Article  PubMed  CAS  Google Scholar 

  • Schweizer, O., Howland, W. S., Sullivan, C., Vertes, E.: 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. Anesthesiology 28, 814 (1967).

    Article  PubMed  CAS  Google Scholar 

  • Severinghaus, J. W., Cullen, S. C.: Depression of myocardium and body oxygen consumption with Fluothane. Anesthesiology 19, 165 (1958).

    Article  PubMed  CAS  Google Scholar 

  • Snodgrass, P. J., Piras, M. M.: Effects of halothane on rat liver mitochondria. Biochemistry 5, 1140 (1966).

    Article  PubMed  CAS  Google Scholar 

  • Stephen, C. R., Grosskreutz, D. C., Lawrence, J. H., Fabian, L. W., Bourgeois-Gavardin, M., Coughlin, J.: Evaluation of Fluothane for clinical anaesthesia. Canad. Anaesth. Soc. J. 4, 246 (1957).

    Article  PubMed  CAS  Google Scholar 

  • Theye, R. A.: Myocardial and total oxygen consumption with halothane. Anesthesiology 28, 1042 (1967).

    PubMed  CAS  Google Scholar 

  • Theye, R. A., Messick, J. M., Jr.: Measurement of oxygen consumption by spirometry during halothane anesthesia. Anesthesiology 29, 361 (1968).

    Article  PubMed  CAS  Google Scholar 

  • Theye, R. A., Sessler, A. D.: Effect of halothane anesthesia on rate of canine oxygen consumption. Anesthesiology 28, 661 (1967).

    Article  PubMed  CAS  Google Scholar 

  • Theye, R. A., Tuohy, G. F.: Oxygen uptake during light halothane anesthesia in man. Anesthesiology 25, 627 (1964).

    Article  PubMed  CAS  Google Scholar 

  • Ueda, I.: Effects of diethyl ether and halothane on firefly luciferin bioluminescence. Anesthesiology 26, 603 (1965).

    Article  PubMed  CAS  Google Scholar 

  • Ueda, I., Mietani, W.: Microsomal ATPase of rabbit brain and effects of general anesthetics. Biochem. Pharmacol. 16, 1370 (1967).

    Article  PubMed  CAS  Google Scholar 

  • Virtue, R. W., Helmreich, M. L., Gainza, E.: The adrenal cortical response to surgery. I. The effect of anesthesia on plasma 17-hydroxycorticosteroid levels. Surgery 41, 549 (1957).

    PubMed  CAS  Google Scholar 

  • Virtue, R. W., Payne, K. W., Caranna, L. J., Gordon, G. S., Rember, R. R.: Observations during experimental and clinical use of Fluothane. Anesthesiology 19, 478 (1958).

    Article  PubMed  CAS  Google Scholar 

  • Willenkin, R. L., Greene, N. M.: Skeletal muscle oxygen tension and metabolism during induced hypotension and during vasopressor administration. Anesthesiology 24, 168 (1963).

    Article  PubMed  CAS  Google Scholar 

  • Wollman, H., Alexander, S. C., Cohen, P. J., Chase, P. E., Melman, E., Behar, M. G.: Cerebral circulation of man during halothane anesthesia: Effects of hypocarbia and of d-tubocurarine. Anesthesiology 25, 180 (1964).

    Article  PubMed  CAS  Google Scholar 

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  1. Nicholas M. Greene
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Editors and Affiliations

  1. Biochemical Research Laboratory, The Dow Chemical Company, Midland, MI, 48640, USA

    Maynard B. Chenoweth

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Greene, N.M. (1972). Metabolic Effects of Anesthetics. In: Chenoweth, M.B. (eds) Modern Inhalation Anesthetics. Handbuch der experimentellen Pharmakologie/Handbook of Experimental Pharmacology, vol 30. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-65055-0_11

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  • DOI: https://doi.org/10.1007/978-3-642-65055-0_11

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