Metabolic effects of glucose compared with invertose and a mixture of fructose, glucose and xylitol before and after moderate surgical trauma

The metabolic and clinical effects of different isocaloric carbohydrate infusions were studied perioperatively in 54 female patients undergoing cholecystectomy. The patients were randomized to six treatment groups, who received infusions only postoperatively (group 1, 2 and 3) or pre- as well as postoperatively (group 4, 5 and 6). One litre was given during 8 h as a 12% infusion solution. Glucose (group 1 and 4) was compared to invertose (group 2 and 5) and to a mixture of fructose, glucose and xylitol 2:1:1 i.e. Triofusin (group 3 and 6). The glycogen content in liver biopsies, taken peroperatively, was significantly higher when infusions were given preoperatively. No significant differences were found between groups, when comparing the different carbohydrate infusions. A minor glucose intolerance was noticed postoperatively, especially in group 4, whereas no fructose or xylitol intolerance was seen. Lactataemia was insignificant and acid-base balance normal in all groups. Serum urea concentrations were lower when preoperative infusions were given but without differences between groups 4, 5 and 6. Electrolytes, creatinine, hemoglobin, hematocrite and liver function tests were unaltered and the clinical course was uncomplicated in all cases. No side effects were observed. It is concluded that the infusion of one litre 12% Triofusin can be used as effectively and safely as 12% glucose and invertose before and after moderate surgical trauma. But no obvious advantage with Triofusin was revealed.