Effect of spinal anaesthesia on perioperative hyperglycemia in diabetic patients undergoing lower limb orthopaedic surgeries
Journal Title: Medpulse International Journal of Anesthesiology - Year 2018, Vol 6, Issue 1
Abstract
Background and Aims: Surgery evokes stress response resulting in increased secretion of counter-regulatory hormones (catecholamines, cortisol, glucagon, and growth hormone) and excessive release of inflammatory cytokines, a state of functional insulin deficiency occurs. Hence, diabetic patients undergoing surgery furtherdevelop hyperglycemia in the intra-operative and postoperative period. The aim of our study was to assess the effect of spinal anaesthesia on perioperative hyperglycemia in diabetic patients undergoing lower limb orthopaedic surgeries and also to state the trend of perioperative hyperglycemia. Methods: In this prospective study, 60 diabetic (D) patients having preoperative blood glucose between 80 to 120mg/dl, undergoing lower limb orthopaedic surgery, under spinal anesthesia were included. During surgery, blood sugar was measured in capillary blood, using glucometer 10 minutes before initiation of anaesthesia, at time of surgical incision (SI), 30 min after incision and thereafter 1hourly till 4th hour after surgical incision. Statistical analysis was done using SPSS 17.0 software. Results: Blood glucose (BG) value decreases till 1hr after surgical incision (SI), and then increases till 4th hr after SI. This change in blood glucose values is statistically significant at SI, 2nd hr after SI, 3rd hr after SI and 4th hr after SI. Conclusion: Spinal anaesthesia blunts surgical stress response and hence, at SI, BG values decrease. But, BG values increase at other times in perioperative period owing tothe regression of sensory analgesia.
Authors and Affiliations
Shaily Gokhru, Shalini Jain
Keywords
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