Influence of abdominal surgical trauma upon some energy metabolites in the quadriceps muscle in man

Thirteen patients with gallbladder disease but otherwise healthy were studied in connection with cholecystectomy. Specimens of the lateral vastus muscle were taken by the percutaneous needle biopsy technique during anesthesia before surgery, on two occasions during surgery and 30 min after discontinuation of anaesthesia. The muscle samples were analysed for glycogen, lactate, citrate, ATP, phosphoryl creatine, creatine and water content. Citrate and lactate concentrations in muscle increased continuously throughout the study. There were no significant changes in the concentration of glycogen, phosphoryl creatine, and ATP in muscle tissue. The increase in citrate concentration is probably related to an augmented uptake and combustion of free fatty acids and 3-hydroxybutyrate in this situation. The data suggest that during anaesthesia and abdominal surgery an increase in the muscle citrate concentration may contribute to the modulation of carbohydrate utilization in skeletal muscle.