Nutritional ketosis delays the onset of isoflurane induced anesthesia

Csilla Ari, Z. Kovács, Cem Murdun, Andrew P. Koutnik, Craig R. Goldhagen, Christopher Rogers, David Diamond, Dominic P. D'Agostino

Research output: Article

3 Citations (Scopus)

Abstract

Background: Ketogenic diet (KD) and exogenous ketone supplements can evoke sustained ketosis, which may modulate sleep and sleep-like effects. However, no studies have been published examining the effect of ketosis on the onset of general isoflurane induced anesthesia. Therefore, we investigated the effect of the KD and different exogenous ketogenic supplements on the onset of akinesia induced by inhalation of isoflurane. Methods: We used a high fat, medium protein and low carbohydrate diet (KD) chronically (10weeks) in the glucose transporter 1 (GLUT1) deficiency (G1D) syndrome mice model and sub-chronically (7days) in Sprague-Dawley (SPD) rats. To investigate the effect of exogenous ketone supplements on anesthetic induction we also provided either 1) a standard rodent chow diet (SD) mixed with 20% ketone salt supplement (KS), or 2) SD mixed with 20% ketone ester supplement (KE; 1,3 butanediol-acetoacetate diester) to G1D mice for 10weeks. Additionally, SPD rats and Wistar Albino Glaxo Rijswijk (WAG/Rij) rats were fed the SD, which was supplemented by oral gavage of KS or KE for 7days (SPD rats: 5g/kg body weight/day; WAG/Rij rats: 2.5g/kg body weight/day). After these treatments (10weeks for the mice, and 7days for the rats) isoflurane (3%) was administered in an anesthesia chamber, and the time until anesthetic induction (time to immobility) was measured. Blood ketone levels were measured after anesthetic induction and correlation was calculated for blood beta-hydroxybutyrate (βHB) and anesthesia latency. Results: Both KD and exogenous ketone supplementation increased blood ketone levels and delayed the onset of isoflurane-induced immobility in all investigated rodent models, showing positive correlation between the two measurements. These results demonstrate that elevated blood ketone levels by either KD or exogenous ketones delayed the onset of isoflurane-induced anesthesia in these animal models. Conclusions: These findings suggest that ketone levels might affect surgical anesthetic needs, or could potentially decrease or delay effects of other narcotic gases.

Original languageEnglish
Article number85
JournalBMC Anesthesiology
Volume18
Issue number1
DOIs
Publication statusPublished - júl. 18 2018

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Ketosis
Isoflurane
Ketones
Anesthesia
Ketogenic Diet
Anesthetics
Sprague Dawley Rats
Rodentia
Sleep
Salts
Body Weight
Carbohydrate-Restricted Diet
3-Hydroxybutyric Acid
Facilitative Glucose Transport Proteins
Narcotics
Inhalation
Esters
Animal Models
Gases
Fats

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Ari, C., Kovács, Z., Murdun, C., Koutnik, A. P., Goldhagen, C. R., Rogers, C., ... D'Agostino, D. P. (2018). Nutritional ketosis delays the onset of isoflurane induced anesthesia. BMC Anesthesiology, 18(1), [85]. https://doi.org/10.1186/s12871-018-0554-0

Nutritional ketosis delays the onset of isoflurane induced anesthesia. / Ari, Csilla; Kovács, Z.; Murdun, Cem; Koutnik, Andrew P.; Goldhagen, Craig R.; Rogers, Christopher; Diamond, David; D'Agostino, Dominic P.

In: BMC Anesthesiology, Vol. 18, No. 1, 85, 18.07.2018.

Research output: Article

Ari, C, Kovács, Z, Murdun, C, Koutnik, AP, Goldhagen, CR, Rogers, C, Diamond, D & D'Agostino, DP 2018, 'Nutritional ketosis delays the onset of isoflurane induced anesthesia', BMC Anesthesiology, vol. 18, no. 1, 85. https://doi.org/10.1186/s12871-018-0554-0
Ari, Csilla ; Kovács, Z. ; Murdun, Cem ; Koutnik, Andrew P. ; Goldhagen, Craig R. ; Rogers, Christopher ; Diamond, David ; D'Agostino, Dominic P. / Nutritional ketosis delays the onset of isoflurane induced anesthesia. In: BMC Anesthesiology. 2018 ; Vol. 18, No. 1.
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abstract = "Background: Ketogenic diet (KD) and exogenous ketone supplements can evoke sustained ketosis, which may modulate sleep and sleep-like effects. However, no studies have been published examining the effect of ketosis on the onset of general isoflurane induced anesthesia. Therefore, we investigated the effect of the KD and different exogenous ketogenic supplements on the onset of akinesia induced by inhalation of isoflurane. Methods: We used a high fat, medium protein and low carbohydrate diet (KD) chronically (10weeks) in the glucose transporter 1 (GLUT1) deficiency (G1D) syndrome mice model and sub-chronically (7days) in Sprague-Dawley (SPD) rats. To investigate the effect of exogenous ketone supplements on anesthetic induction we also provided either 1) a standard rodent chow diet (SD) mixed with 20{\%} ketone salt supplement (KS), or 2) SD mixed with 20{\%} ketone ester supplement (KE; 1,3 butanediol-acetoacetate diester) to G1D mice for 10weeks. Additionally, SPD rats and Wistar Albino Glaxo Rijswijk (WAG/Rij) rats were fed the SD, which was supplemented by oral gavage of KS or KE for 7days (SPD rats: 5g/kg body weight/day; WAG/Rij rats: 2.5g/kg body weight/day). After these treatments (10weeks for the mice, and 7days for the rats) isoflurane (3{\%}) was administered in an anesthesia chamber, and the time until anesthetic induction (time to immobility) was measured. Blood ketone levels were measured after anesthetic induction and correlation was calculated for blood beta-hydroxybutyrate (βHB) and anesthesia latency. Results: Both KD and exogenous ketone supplementation increased blood ketone levels and delayed the onset of isoflurane-induced immobility in all investigated rodent models, showing positive correlation between the two measurements. These results demonstrate that elevated blood ketone levels by either KD or exogenous ketones delayed the onset of isoflurane-induced anesthesia in these animal models. Conclusions: These findings suggest that ketone levels might affect surgical anesthetic needs, or could potentially decrease or delay effects of other narcotic gases.",
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AU - Goldhagen, Craig R.

AU - Rogers, Christopher

AU - Diamond, David

AU - D'Agostino, Dominic P.

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N2 - Background: Ketogenic diet (KD) and exogenous ketone supplements can evoke sustained ketosis, which may modulate sleep and sleep-like effects. However, no studies have been published examining the effect of ketosis on the onset of general isoflurane induced anesthesia. Therefore, we investigated the effect of the KD and different exogenous ketogenic supplements on the onset of akinesia induced by inhalation of isoflurane. Methods: We used a high fat, medium protein and low carbohydrate diet (KD) chronically (10weeks) in the glucose transporter 1 (GLUT1) deficiency (G1D) syndrome mice model and sub-chronically (7days) in Sprague-Dawley (SPD) rats. To investigate the effect of exogenous ketone supplements on anesthetic induction we also provided either 1) a standard rodent chow diet (SD) mixed with 20% ketone salt supplement (KS), or 2) SD mixed with 20% ketone ester supplement (KE; 1,3 butanediol-acetoacetate diester) to G1D mice for 10weeks. Additionally, SPD rats and Wistar Albino Glaxo Rijswijk (WAG/Rij) rats were fed the SD, which was supplemented by oral gavage of KS or KE for 7days (SPD rats: 5g/kg body weight/day; WAG/Rij rats: 2.5g/kg body weight/day). After these treatments (10weeks for the mice, and 7days for the rats) isoflurane (3%) was administered in an anesthesia chamber, and the time until anesthetic induction (time to immobility) was measured. Blood ketone levels were measured after anesthetic induction and correlation was calculated for blood beta-hydroxybutyrate (βHB) and anesthesia latency. Results: Both KD and exogenous ketone supplementation increased blood ketone levels and delayed the onset of isoflurane-induced immobility in all investigated rodent models, showing positive correlation between the two measurements. These results demonstrate that elevated blood ketone levels by either KD or exogenous ketones delayed the onset of isoflurane-induced anesthesia in these animal models. Conclusions: These findings suggest that ketone levels might affect surgical anesthetic needs, or could potentially decrease or delay effects of other narcotic gases.

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KW - Isoflurane

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KW - Rodent models

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