Surgical researchers in Canada have found that oral glutamine can reduce length of hospital stay by a full day following elective surgery. Recent study results have prompted surgeons at the University of Saskatchewan in Saskatoon to make glutamine administration part of standard preoperative management for general and orthopedic surgery patients. The amino acid reduces oxidative stress and improves clinical outcomes.
    "Within the first 24 hours after an operation, there is a great need for this substance to balance out the release of free radicals," explained surgical research associate Adebola Obayan, MD. "Having glutamine in the circulation before a surgical procedure does patients more good than it does afterward."
   Surgery is a traumatic experience that produces oxidative stress, he told the American College of Surgeons Clinical Congress. In response to surgical trauma, muscle tissue is broken down to produce glutamine, which enhances tissue repair and the recovery of body systems.
   A single major surgical procedure can deplete up to 40% of normal glutamine levels and reduce lean body mass. Loading the system with glutamine before surgery prevents the metabolism of muscle tissue into glutamine and reduces oxidative stress, Dr. Obayan explained.
   The policy change was prompted by a prospective, randomized, double blind trial with 69 patients who had elective surgery between October 2002 and April 2003. Patients received 0.3 g/kg alanylglutamine, a stable form of glutamine, via tube feedings within eight hours of surgery. Oxidative stress indicators were measured for 72 hours after surgery.
   Researchers found that glutamine supplementation boosted circulating levels of glutamine and antioxidants during the entire 72-hour test period. Glutamine also eliminated the loss of lean body mass and decreased the production of oxidants. Patients who received glutamine were discharged a day earlier than control patients.
   "Glutamine is a precursor of glutamate and it enhances the synthesis of glutathione, the body's principal antioxidant," Dr. Obayan said. "In the past, if glutamine was given, it was administered with other nutrients. This study showed that glutamine affects hospital stay on its own."
   Dr. Obayan recommended the use of glutamine for all major surgery patients.