A Prospective Study Determining the Impact of Spinal Anaesthesia on Perioperative Hyperglycemia in Diabetic Patients Undergoing Lower Limb Orthopaedic Surgeries
- 1. Senior Resident, Department of Anaesthesia, BMIMS Pawapuri, Nalanda, Bihar, India
- 2. Associate Professor and HOD, BMIMS Pawapuri, Nalanda, Bihar, India
Description
Abstract
Aim: The aim of the present 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.
Material & Methods: A prospective study conducted in the Department of Anaesthesia for the duration of 12
months including 100 patients having either Type I or Type II Diabetes Mellitus controlled on either oral
hypoglycaemic drugs or injectable insulin aged 30 to 65 years, belonging to either sex and American Society of
Anesthesiologists (ASA) physical status II and III undergoing elective lower limb orthopaedic surgeries under
spinal anaesthesia.
Results: The mean age, weight, height and duration of anaesthesia was 50.52±12.68 years, 62.8±5.6 kg, 160.8±4.6
cm and 104.6±10.5 respectively. Mean BG value preoperatively or 10min before induction was 111.58±11.084.
Then at SI, there was statistically significant decrease in BG value to mean value 106.84±13.57. 30min after SI,
mean BG value was 108.72±18.92. This value was lower as compared to the pre-operative BG value, but not
statistically significant. 1hr after SI, BG value was 110.60±12.228. This value was also lower as compared to the
pre-operative BG value, but not statistically significant. 2hrs after SI, BG value increased to mean value
121.86±18.442. Even, 3 hrs after SI, BG value continued increasing and the mean value became 124.12±16.004.
4 hrs after SI, BG value was maximum with the value being 126.24±15.385. There was statistically significant
difference (p=.000). 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 to the regression of sensory analgesia.
Abstract (English)
Abstract
Aim: The aim of the present 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.
Material & Methods: A prospective study conducted in the Department of Anaesthesia for the duration of 12
months including 100 patients having either Type I or Type II Diabetes Mellitus controlled on either oral
hypoglycaemic drugs or injectable insulin aged 30 to 65 years, belonging to either sex and American Society of
Anesthesiologists (ASA) physical status II and III undergoing elective lower limb orthopaedic surgeries under
spinal anaesthesia.
Results: The mean age, weight, height and duration of anaesthesia was 50.52±12.68 years, 62.8±5.6 kg, 160.8±4.6
cm and 104.6±10.5 respectively. Mean BG value preoperatively or 10min before induction was 111.58±11.084.
Then at SI, there was statistically significant decrease in BG value to mean value 106.84±13.57. 30min after SI,
mean BG value was 108.72±18.92. This value was lower as compared to the pre-operative BG value, but not
statistically significant. 1hr after SI, BG value was 110.60±12.228. This value was also lower as compared to the
pre-operative BG value, but not statistically significant. 2hrs after SI, BG value increased to mean value
121.86±18.442. Even, 3 hrs after SI, BG value continued increasing and the mean value became 124.12±16.004.
4 hrs after SI, BG value was maximum with the value being 126.24±15.385. There was statistically significant
difference (p=.000). 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 to the regression of sensory analgesia.
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Additional details
Dates
- Accepted
-
2023-09-22