Perioperative Changes of Erythrocyte Pyruvate Kinase Activity in Patients Undergoing Upper Abdominal Surgery

The purpose of this study is to investigate the perioperative changes of erythrocyte kinase (PK) activity. Thirty patients undergoing upper abdominal surgery were dirided into epidural blockade(EB) group or intra venous procaine balanced anesthesia(IPBA) group. The blood level of glucose increased significantly at 60 min after the beginning of operations in both groups. Blood glucose levels on the first postoperative day were significantly higher than the baselines in both groups [(8. 29±1. 5)vs (4. 8±0.18) mmol/L (P< 0.01) in EB, (6.36±0.33) vs (4. 55±0.18 ) mmol/L (P<0. 01 ) in IPBA]. The concentrations of 2, 3-DPG in RBC were not significantly changed in both groups. The PK activity in RBC decreased signficantly at 60 min after the end of operation in both groups. The PK activity levels on the first postoperative day were significantly lower than the baselines in both groups [(7. 59±1. 01) vs (11. 62±1. 06) IU/gHb (P<0. 05) in EB; (7. 75±0. 94) vs (11. 84 ±1.12) IU/gHb (P<0. 05 ) in IPBA]. The results suggest that the PK activity is decreased and the concentration of 2, 3-DPG remians unchanged under the hyperglycemic response to surgical stress, which may be related to an inhibition of glycolysis in RBC.