Evaluation of Amino Acid Infusion preventive effect on Hypothermia during Spinal Anesthesia for Hip Arthroplasty

Document Type : RESEARCH PAPER

Authors

1 Department of Anesthesiology, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Lung Disease Research Center, Department of Anesthesiology, Mashhad University of Medicine Sciences, Mashhad, Iran

3 Lung Diseases Research Center, Mashhad University of Medicine Sciences, Mashhad, Iran

4 Faculty of Medicine Mashhad University of Medicine Sciences, Mashhad, Iran

Abstract

Background: Hypothermia increases bleeding during surgery, risk of ischemic heart disease and postoperative wound
infection. Intravenous amino acid increases cell synthesis and produces heat. Our goal was evaluating of the effect of
amino acid on intraoperative hypothermia under spinal anesthesia.
Methods: This is a randomized, double-blinded clinical trial that 36 adults undergoing Hip Arthroplasty were randomly
assigned into two groups of 18 each. One group received Amino Acids solution (Aminoven 10%) 500ml (240ml/h)
throughout spinal anesthesia, and control group received saline solution. We measured core body temperature, MAP
and HR each 10 minutes, and also postoperative shivering, blood loss, operation time, postoperative BUN and Cr were
compared in two groups.
Results: Throughout surgery, the reduction in core temperature was more in the control group than the amino acids
group (statistically not clinically). The decrease in core temperature was significantly larger in the controls (0.96°C
± 0.7°C) than in the amino acid patients (0.94°C ± 0.4°C), (P value= 0.02). Postoperative shivering was 73% in the
controls regarding 11% in the amino acids patients. Overall, there were no significant statistical differences between
other variables that we measured in two groups of patients.
Conclusion: Amino acids infusion during spinal anesthesia exerted a thermogenic effect. Our findings showed
hypothermia was less in the aminoacid group, and also postoperative shivering was more in the control group.
Level of evidence: I

Keywords

References

  1. Zeba S, Šurbatović M, Jevtić M, Filipović N, Popović N, Radaković S, et al. Influence of perioperative administration of amino acids on thermoregulation response in patients underwent colorectal surgical procedures. Vojnosanitetski pregled. 2007;64(6):421-4.
  2. Taghaddomi RJ, Mashhadinezhad H, Attar AS, Peivandi A. The effect of intravenous tranexamic acid on blood loss in lumbar hernial disc resection under inhalation and total intravenous anesthesia. Iranian Red Crescent Medical Journal. 2009;11(3):265.
  3. Widman J, Hammarqvist F, Selldén E. Amino acid infusion induces thermogenesis and reduces blood loss during hip arthroplasty under spinal anesthesia. Anesthesia & Analgesia. 2002;95(6):1757-62.
  4. Xu Q, Zhu M, Li Z, Zhu J, Xiao F, Liu F,et al. Enhanced recovery after surgery protocols in patients undergoing liver transplantation: A retrospective comparative cohort study. Int J Surg. 2020;78:108-112.
  5. Melloul E, Lassen K, Roulin D, Grass F, Perinel J, Adham M, et al. Guidelines for Perioperative Care for Pancreatoduodenectomy: Enhanced Recovery After Surgery (ERAS) Recommendations 2019. World J Surg. 2020;44(7):2056-2084.
  6. Mizobe T, Nakajima Y. Dietary-induced thermo-genesis and perioperative thermoregulation. Masui The Japanese journal of anesthesiology. 2007;56(3):305-16.
  7. Sahin A, Aypar U. Effect of amino acid solutions on intraoperative hypothermia and postoperative Comparison of two anesthetic regimens. Acta anaesthesiologica scandinavica. 2002;46(1):64-7.
  8. Sellden E, Bränström R, Brundin T. Preoperative infusion of amino acids prevents postoperative hypothermia. British journal of anaesthesia. 1996;76(2):227-34.
  9. Selldén E, Lindahl SG. Amino acid-induced thermogenesis reduces hypothermia during anesthesia and shortens hospital stay. Anesthesia & Analgesia. 1999;89(6):1551.
  10. Yamaoka I. Modification of core body temperature by amino acid administration. Asia Pacific journal of clinical nutrition. 2008;17(S1):309-11.
  11. Duthie DR. Aminoacid infusions to prevent postoperative hypothermia. The Lancet. 1996;347(9010):1199.
  12. Kamitani K, Higuchi A, Nohara A, Takagi M, Tokutake M, Horikawa H, et al. Effect of amino acid solution on intraoperative core temperature the influence of anesthetics. Masui The Japanese journal of anesthesiology. 2005;54(11):1258-62.
  13. Kamitani K, Yoshida H, Takagi M, Minami M, Tokutake M, Kishi R, et al. Effect of amino acid infusion for prevention of intraoperative hypothermia during laparotomy. Masui The Japanese journal of anesthesiology. 2006;55(10):1216-21.
  14. Chandrasekaran T, Morgan R, Mason R, Mangat P, Watkins A, Carr N. Nutrient induced thermogenesis during major colorectal excision–a pilot study. Colorectal Disease. 2005;7(1):74-8.
  15. Yokoyama T, Yamaoka I, Hitosugi T, Selldén E. Amino Acids during Perioperative Period. Open Journal of Anesthesiology. 2017;7(09):287.
  16. Moriyama T, Tsuneyoshi I, Omae T, Takeyama M, Kanmura Y. The effect of amino-acid infusion during off-pump coronary arterial bypass surgery on thermogenic and hormonal regulation. Journal of anesthesia. 2008;22(4):354.
  17. Lee LI, Lin CC, Chen MC, Lin CH, Shyr MH. Anesthesia duration and hypothermia affect graft survival in vascularized free flap surgery. Tzu Chi Med J. 2005;17:17–20.
  18. Agrawal N, Sewell DA, Griswold ME, Frank SM, Hessel TW, Eisele DW. Hypothermia during head and neck surgery. Laryngoscope. 2003;113:1278–82.
  19. Sessler DI ,Miller RD, editor. Temperature monitoring . Anesthesia. 5thed. Churchill Livingstone; 2000. pp. 1367–89
  20. Gupta N, Sehgal R, Kumar R, Sharma KR, Gupta A, Agrawal N. A prospective randomized double blind study to evaluate the effect of infusion of amino acid enriched solution on recovery from neuromuscular blockade.Indian J Anaesth.2009;53:318–23.
  21. Sun X, Yang H, Li X, Wang Y, Zhang C, Song Z, et al. Randomized controlled trial of moderate hypothermia versus deep hypothermia anesthesia on brain injury during Stanford A aortic dissection surgery. Heart and vessels. 2018;33(1):66-71.
  22. Insler SR, Sessler DI. Perioperative thermoregulation and temperature monitoring. Anesthesiol Clin. 2006 Dec;24(4):823-37.
The Archives of Bone and Joint Surgery
Volume 10, Issue 7
July 2022
Pages 627-632

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History

  • Receive Date: 02 February 2021
  • Revise Date: 13 December 2021
  • Accept Date: 02 January 2022

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