Metabolic Syndrome and Perioperative Complications During Elective Surgery Using General Anesthesia
Keywords:
Insulin resistance General anesthesia Medicine Cardiovascular diseases
Abstract
Introduction: Metabolic Syndrome (MS) is a cluster of alterations associated to high risk of cardiovascular diseases and diabetes mellitus. Although Metabolic Syndrome is a public health issue, little has been studied about its impact in the anesthetic-surgical scene.
Aims: To analyze the correlation level between MS and perioperative complications, in patients under programmed surgery with general anesthesia technique in Cartagena, Colombia.
Materials and methods: A case control study was designed, where 300 patients were enrolled: 150 cases and 150 controls. Socio-demographic, hemodynamics and respiratory variables, as well as surgical complications (hypotension, hypertension, hypoxemia, bleeding, moderated-severe pain and post chirurgical nausea-vomiting) were registered. Fisher’s exact test and X2, where appropriated were employed to compare categorical data. A logistic regression model was applied to calculate correlation between variables.
Results: Surgical complications were more frequent in cases group (P<.001). Differences in age and ASA physical status were also found (P<.05). MS was correlated to perioperative complications (OR: 3.31; P<.05). ASA III physical status was another risk factor to post chirurgical complications development (OR: 4.01; P<.05). None mortality case was reported.
Conclusions: In a comparison with healthy population, Metabolic Syndrome represented a risk factor to perioperative complications development. According to results, further prevention and approach guidelines in order to reduce perioperative complications associated to Metabolic Syndrome.
References
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14. Biccard BM. A peri-operative statin update for non-cardiac surgery. Part I: The effects of statin therapy on atherosclerotic disease and lessons learnt from statin therapy in medical (non-surgical) patients. Anaesthesia. 2008;63:52-64.
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16. Kuchta KF. Pathophysiologic changes of obesity. Anesthesiol Clin North Am. 2005;23:421-9.
17. Seematter G, Binnert C, Martin JL, Tappy L. Relationship between stress, inflammation and metabolism. Curr Opin Clin Nutr Metab Care. 2004;7:169-73.
18. Donatelli F, Cavagna P, Di Dedda G, Catenacci A, Di Nicola M, Lorini L, et al. Correlation between pre-operative metabolic syndrome and persistent blood glucose elevation during cardiac surgery in non-diabetic patients. Acta Anaesthesiol Scand. 2008;52:1103-10.
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26. Liu W, Lin R, Liu A, Du L, Chen Q. Prevalence and association between obesity and metabolic syndrome among Chinese elementary school children: a school-based survey. BMC Public Health. 2010;10:780.
28. Alegría E, Cordero A, Casanovas JA. Prevalencia del síndrome metabólico en población laboral española. Rev Esp Cardiol. 2005;58:797-806.
29. López-Jaramillo P, Silva S, Ramírez F, García R. Síndrome metabólico: diagnóstico y prevención. Acta Med Colomb. 2004;29:137-44.
30. Isoma B, Alegren P, Toumi T, Forsen B, Latí K, Nissen M, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care. 2001; 24:683-9.
31. Greer DM, Hill DC. Implementing an evidence-based metabolic syndrome prevention and treatment program utilizing group visits. J Am Acad Nurse Pract. 2011;23: 76-83.
32. Enrique-Santos D. Fisiopatología de la respuesta inflamatoria durante el perioperatorio. Rev Mex Anestesiol. 2007;30:S157-9.
33. Aekplakorn W, Chongsuvivatwong V, Tatsanavivat P, Suriyawongpaisal P. Prevalence of metabolic syndrome defined by the International Diabetes Federation and National Cholesterol Education Program criteria among Thai adults. Asia Pac J Public Health. 2011;23:792-800.
34. Sinha AC. Some anesthetic aspects of morbid obesity. Curr Opin Anaesthesiol. 2009;22:442-6.
35. Neligan PJ. Metabolic syndrome: anesthesia for morbid obesity. Curr Opin Anaesthesiol. 2010;23:375-83.
2. Mlinar B, Marc J, Janež A, Pfeifer M. Molecular mechanisms of insulin resistance and associated diseases. Clin Chim Acta. 2007;375:20-35
3. Wells GD, Noseworthy MD, Hamilton J, Tarnopolski M, Tein I. Skeletal muscle metabolic dysfunction in obesity and metabolic syndrome. Can J Neurol Sci. 2008;35:31-40. Erratum in: Can J Neurol Sci. 2008;35:402.
4. Kuchta KF. Pathophysiologic changes of obesity. Anesthesiol Clin North Am. 2005;23:421-9.
5. Pradilla Suarez L, Lopez Jaramillo P, Bracho YT. Papel del adipocito en la inflamación del síndrome metabólico. Acta Médica Colombiana. 2005;30:137-40.
6. Grundy SM, Cleeman JI. Diagnosis and management of the metabolic syndrome. An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement Executive Summary. Circulation. 2005;112:e285-e90.
7. Alberti KGMM, Zimmet P, Shaw J. Metabolic syndrome -A new world-wide definition, a consensus statement from the International Diabetes Federation. Diabet Med. 2006;23:469-80.
8. Garcia Gomez R, Cifuentes A, Caballero R, Sanchez L, Lopez Jaramillo P. A proposal for an appropriate central obesity diagnosis in Latin American population. Int J Cardiol. 2006;110:263-4.
9. Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes. 1988;37:1595-607.
10. Einhorn D, Reaven GM, Cobin RH, Ford E, Ganda OP, Handelsman Y, et al. American Association of Clinical Endocrinology position statement on insulin resistance syndrome. Endocr Pract. 2003;9:237-52.
11. Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998;15:539-53.
12. National Institutes of Health. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final Report. Circulation. 2002;106:3143.
13. Seematter G, Binnert C, Tappy L. Stress and metabolism. Metab Syndr Relat Disord. 2005;3:8-13.
14. Biccard BM. A peri-operative statin update for non-cardiac surgery. Part I: The effects of statin therapy on atherosclerotic disease and lessons learnt from statin therapy in medical (non-surgical) patients. Anaesthesia. 2008;63:52-64.
15. Whelan DM, Roy RC. Diseases of aging that emerge from the metabolic syndrome. Anesthesiol Clin. 2006;24:599-619.
16. Kuchta KF. Pathophysiologic changes of obesity. Anesthesiol Clin North Am. 2005;23:421-9.
17. Seematter G, Binnert C, Martin JL, Tappy L. Relationship between stress, inflammation and metabolism. Curr Opin Clin Nutr Metab Care. 2004;7:169-73.
18. Donatelli F, Cavagna P, Di Dedda G, Catenacci A, Di Nicola M, Lorini L, et al. Correlation between pre-operative metabolic syndrome and persistent blood glucose elevation during cardiac surgery in non-diabetic patients. Acta Anaesthesiol Scand. 2008;52:1103-10.
19. ASA Relative Value Guide. American Society of Anesthesiologists; 2002. p. XII.
20. Keats AS. The ASA Clasification of physical status -a recapitulation. Anesthesiology. 1978;49:233.
21. Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery. ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2007;116:1971-96.
22. Botero JC, Salazar D, Cortez O. Metabolic syndrome and cardiovascular risk. Rev CES Med. 2006;20:73-81.
23. Escobedo J, Schargrodsky H, Champagne B, Silva H, Boissonnet CP, Vinueza R, et al. Prevalence of the metabolic syndrome in Latin America and its association with subclinical carotid atherosclerosis: the CARMELA cross sectional study. Cardiovasc Diabetol. 2009;8:52.
24. Resolución 2378 de junio 27 de 2008 del Ministerio de Protección Social Disponible en: http://minproteccionsocial.gov.co/vbecontent/NewsDetail.asp?ID=17866 citado Jul 2010.
25. Elizondo-Montemayor L, Serrano-González M, Ugalde-Casas PA, Bustamante-Careaga H, Cuello-García C. Waist-to-Height: Cutoff Matters in Predicting Metabolic Syndrome in Mexican Children. Metab Syndr Relat Disord. 2011 Epub ahead of print .
26. Liu W, Lin R, Liu A, Du L, Chen Q. Prevalence and association between obesity and metabolic syndrome among Chinese elementary school children: a school-based survey. BMC Public Health. 2010;10:780.
28. Alegría E, Cordero A, Casanovas JA. Prevalencia del síndrome metabólico en población laboral española. Rev Esp Cardiol. 2005;58:797-806.
29. López-Jaramillo P, Silva S, Ramírez F, García R. Síndrome metabólico: diagnóstico y prevención. Acta Med Colomb. 2004;29:137-44.
30. Isoma B, Alegren P, Toumi T, Forsen B, Latí K, Nissen M, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care. 2001; 24:683-9.
31. Greer DM, Hill DC. Implementing an evidence-based metabolic syndrome prevention and treatment program utilizing group visits. J Am Acad Nurse Pract. 2011;23: 76-83.
32. Enrique-Santos D. Fisiopatología de la respuesta inflamatoria durante el perioperatorio. Rev Mex Anestesiol. 2007;30:S157-9.
33. Aekplakorn W, Chongsuvivatwong V, Tatsanavivat P, Suriyawongpaisal P. Prevalence of metabolic syndrome defined by the International Diabetes Federation and National Cholesterol Education Program criteria among Thai adults. Asia Pac J Public Health. 2011;23:792-800.
34. Sinha AC. Some anesthetic aspects of morbid obesity. Curr Opin Anaesthesiol. 2009;22:442-6.
35. Neligan PJ. Metabolic syndrome: anesthesia for morbid obesity. Curr Opin Anaesthesiol. 2010;23:375-83.
How to Cite
1.
Pomares J, Palomino R R, J. Gómez C, Gómez‑Camargo D. Metabolic Syndrome and Perioperative Complications During Elective Surgery Using General Anesthesia. Colomb. J. Anesthesiol. [Internet]. 2012 Apr. 1 [cited 2024 May 5];40(2):106-12. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/818
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Published
2012-04-01
How to Cite
1.
Pomares J, Palomino R R, J. Gómez C, Gómez‑Camargo D. Metabolic Syndrome and Perioperative Complications During Elective Surgery Using General Anesthesia. Colomb. J. Anesthesiol. [Internet]. 2012 Apr. 1 [cited 2024 May 5];40(2):106-12. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/818
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