Wei Y, Zhang D, Liu J, et al. - General anesthesia and surgery may influence metabolic status. Researchers sought to determine the precise effects of general anesthesia and surgery on systemic metabolome, which might contribute to postoperative outcomes. Among 500 included patients who underwent abdominal surgery, general anesthesia was mainly maintained with sevoflurane and the end-tidal sevoflurane concentration (ET _sevo ) was adjusted to maintain BIS (Bispectral index) value between 40 and 60. Calculation of The mean ET _sevo was done from 20 min after endotracheal intubation to 2 h after the beginning of surgery for each patient. Metabolomic analysis was conducted including patients with low ET _sevo (n = 55) and high ET _sevo (n = 59). In these 114 patients, sevoflurane and abdominal surgery were noted to produce disturbance in the tricarboxylic acid cycle as identified by raised citrate and cis-aconitate levels and to have impact on glycometabolism as identified by raised sucrose and D-glucose levels. These findings suggest that in clinical patients, principal metabolic pathways including tricarboxylic acid cycle, glycometabolism and glutamate metabolism are influenced by sevoflurane anesthesia and abdominal surgery.