Study of effect of spinal anaesthesia on perioperative hyperglycemia in non-diabetic patients undergoing lower limb orthopaedic surgeries
Journal Title: Medpulse International Journal of Anesthesiology - Year 2018, Vol 5, Issue 3
Abstract
Background and Aims: The stress of surgery results in increased levels of gluco-regulatory hormones and excessive release of inflammatory cytokines. The counter-regulatory response produces alterations in carbohydrate metabolism, including insulin resistance, increased hepatic glucose production, impaired peripheral glucose utilization, and relative insulin deficiency. The aim of our study was to assess the effect of spinal anaesthesia on perioperative hyperglycemia in non diabetic patients undergoing lower limb orthopaedic surgeries and also to state the trend of perioperative hyperglycemia. Methods: In this prospective study, 60 non diabetic (ND) 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 at 30min and 1hr after surgical incision (SI), and then increased progressively till the4thhr after SI. This change in blood glucose values is statistically significant only at SI. Conclusion: Surgery evokes stress response due to increased secretion of catabolic hormones. Spinal anaesthesia blunts surgical stress response and hence, blood glucose values remain stable i.e near to their respective pre-operative values except at surgical incision.
Authors and Affiliations
Shaily Gokhru, Shalini Jain
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