Efficacy of different doses of ulinastatin for prevention of insulin resistance in patients undergoing partialhepatectomy

Objective To evaluate the efficacy of different doses of ulinastatin for prevention of insulin resistance in the patients undergoing partial hepatectomy. Methods Sixty patients of both sexes, aged 33-71 yr, weighing 44-70 kg, of ASA physical status Ⅰor Ⅱ, scheduled for electivepartial hepatectomy, were randomly assigned into 3 groups(n=20 each)using a random number table: control group(group C), low dose of ulinastatin group(group UL)and high dose of ulinastatin group(group UH). Before induction of anesthesia and at the beginning of operation, ulinastatin 2 500 U/kg and 5 000 U/kg(in 20 ml of normal saline)were injected intravenously in UL and UH groups, respectively.The equal volume of normalsaline was given instead of ulinastatin in group C. Before skin incision, before removal of the liver, after removal of the liver, and after closure of the abdominal cavity, blood samples were taken from the right internal jugular vein for determination of plasma glucose, insulin and glucagon concentrations.Insulin sensitivity index was calculated. Results Compared with group C, insulin sensitivity index was significantly increased, and the plasma glucose and insulin concentrations were decreased in UL and UH groups. Conclusion Ulinastatin 2 500 U/kg injected intravenously before induction of anesthesia and at beginning of operation can effectively prevent insulin resistance in the patients undergoing partial hepatectomy. Key words: Trypsin inhibitors; Insulin resistance; Hepatectomy