Amino Acids during Perioperative Period

作     者：Takeshi Yokoyama Ippei Yamaoka Takashi Hitosugi Eva Selldén 

作者机构：Department of Dental Anesthesiology Faculty of Dental Science Kyushu University Fukuoka Japan Medical Foods Research Institute OS-1 Division Otsuka Pharmaceutical Factory Inc. Naruto Japan Anestesi- Operations-och Intensivvå rdskliniken Karolinska Universitetssjukhuset Solna Stockholm Sweden 

出 版 物：《Open Journal of Anesthesiology》 (麻醉学期刊（英文）)

年 卷 期：2017年第7卷第9期

页      面：287-295页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Anesthesia Hypothermia Amino Acids Nutrition 

摘      要：During anesthesia, thermoregulation is impaired and hypothermia will frequently occur in most patients. Hypothermia affects immunologic activity, bleeding tendency and the recovery from anesthesia. Therefore, it may prolong hospital stay, and increase morbidity, e.g. surgical site infections, cardiac events and multiple organ dysfunctions in trauma. External warming is often used to prevent hypothermia. However, infusion of amino acids is also valuable to prevent hypothermia due to their enhanced thermogenic action under anesthesia. During surgery, amino acids administration would maintain the body homeostasis, and counteract the disadvantageous fasting metabolism. Postoperatively, amino acids may be advantageous for the healing of the surgical wound. Thus, appropriate nutritional management, including glucose, during the perioperative period would prevent catabolism, frequently occurring after surgery. Protocols like ERAS (Enhanced Recovery After Surgery) are proposed for quick recovery after surgery. ERAS protocol recommends preoperative carbohydrate and early enteral nutrition, but does not include infusion of amino acids during the perioperative period. During prolonged surgery, patients clearly need good nutritional support. In this article, we intend to describe the problems of hypothermia briefly, and explain the mechanism of amino acids in hypothermia prevention. In addition, we address some evidences of nutritional management during the perioperative period.