The Effects of Arginine and Glutamine Used Before Laparoscopic Cholecystectomy on Postoperative Stress Hormones

Abstract

Objective: Enteral nutrition products containing amino acids of glutamine and arginine were administered to patients to be operated under general anesthesia and the response of stress hormones after surgery was evaluated after surgery. The aim of this study is to examine the effect of enteral nutrition, which is provided 3 days before the surgery and includes glutamine and arginine amino acids, on the stress hormones of the patients. Materials and Methods: In this study, a total of 60 patients were included and randomly assigned to three different groups (n = 20): glutamine group, arginine group, and control group. The patients who were above 18, were classified as ASA 1-2, and were not pregnant were recruited in this study. All groups except the control group were administered with glutamine (3*2) and arginine (2*1) 3 days before the study was conducted. Cortisol, insulin, insulin resistance, and glucose levels were measured at the 3rd and 24th hour before and after the surgery. All of the participants underwent laparoscopic cholecystectomy in the general surgery clinic department. Results: Although significant results were obtained regarding the insulin and insulin drain groups in the glutamine and arginine groups compared with the control group, no significant results were found between the glutamine and arginine groups. Among the three groups, significant results were obtained from the arginine group. When all groups were compared, the hospital stay of the patients in the arginine group was shorter than the others. Moreover, the insulin resistance and cortisol levels in the arginine group were slightly increased. Conclusion: Overall, it was observed that arginine and glutamine amino acids administered before surgery can reduce the surgical stress levels of patients.