the patients undergoing elective gastrectomy
Conditions
Interventions
Intervention type:DRUG
Name of intervention: high dose remifentanil
Dose form / Japanese Medical Device Nomenclature:INJECTION
Route of administration / Site of application:INTRAVENOUS DRIP
Dose per
Sponsors
School of Nutrition & Dietetics, Kanagawa University of Human Services
Department of Anesthesiology, Kanagawa Cancer Center
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Subjects were patients scheduled to undergo laparotomic or laparoscopic elective gastrectomy (total gastrectomy, distal gastrectomy, or fundectomy). They met all the following eligibility criteria, and none of the exclusion criteria described below applied to any of the subjects. Eligibility criteria were as follows: Age ?45 and <75 years, American Society of Anesthesiologists physical status (ASA-PS) grade I or II, and informed consent obtained from the patient in writing prior to enrollment.
Exclusion criteria
Exclusion criteria: Exclusion criteria were as follows: advanced cancer-related muscle protein catabolism prior to surgery(serum albumin 3.0 g/dL, total lymphocyte count in peripheral blood 1200 per field of vision, subjective global assessment of nutritional status grade C, or CRP 1.0 mg/dL in the absence of obvious infection), history of ischemic heart disease or cerebrovascular disturbance, evident renal dysfunction (creatinine clearance 20 mL/min, or patients on dialysis), evident electrolyte disturbance (values outside normal limits for our facility), steroid administration, morbid obesity (body mass index, BMI over 35), and hemoglobin A1c (HbA1C) >6.5% (irrespective of type of treatment or complications of diabetes). Cases where 1) the intraoperative blood loss exceeded 500 mL, 2) the surgical procedure was changed intraoperatively, 3) insulin or glucose administration was required during surgery for the purpose of blood glucose control, or 4) remifentanil dosage departed from the prescribed dose, were treated as having discontinued or dropped out of the study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Homeostasis model assessment as an index of insulin resistance (HOMA-IR) 3-methylhistidine/creatinine (3-MH/Cr) | — |
Secondary
| Measure | Time frame |
|---|---|
| intraoperative stress hormones(ACTH,cortisol,adrenarin etc.) , insulin, and blood glucose | — |
Countries
Japan
Contacts
Public ContactHIDEKI TANIGUCHI
School of Nutrition & Dietetics, Kanagawa University of Human Services
Outcome results
None listed