Blood Glucose Levels in Children During Surgery

Watson, B. G.

doi:10.1093/bja/44.7.712

Cited by 45 publications

(20 citation statements)

References 2 publications

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“…[2][3][4] Although several clinicians have reported maintenance of normoglycaemia preoperatively, and hyperglycaemic response to surgery and anaesthesia in healthy children in spite of fasting; [5][6][7][8][9][10][11][12][13][14] others have observed hypoglycaemia in a significant minority. [3,[15][16][17][18][19][20][21][22][23] Failure to demonstrate hyperglycaemia or outright hypoglycaemic response to anaesthesia and surgery has been reported by a few. [19,24] A high incidence of preoperative hypoglycaemia was observed among low percentile weight children (40%) by Ilori et al [3] Hypoglycaemia could be a cause of significant morbidity and mortality in the perioperative periods.…”

Section: Introductionmentioning

confidence: 99%

“…These include 5%, 2.5%, 2%, and 1%. [14][15][16][17][18][19][20][21][22][23][24] However, these are not commercially available in many centres in the sub-Sahara and the pharmacy departments may not be adequately equipped to handle production of these fluids. Currently 4.3% dextrose in 0.18% saline (DS) is the fluid being used in many centres in Nigeria for paediatric perioperative fluid management.…”

Section: Introductionmentioning

confidence: 99%

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Perioperative blood glucose in a paediatric daycase facility: Effects of fasting and maintenance fluid

Adenekan

2014

Afr J Paediatr Surg

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Perioperative blood glucose in a paediatric daycase facility: Effects of fasting and maintenance fluid

Adenekan

2014

Afr J Paediatr Surg

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“…The patients with these low levels did not show any clinical signs suggestive of hypoglycaemia but it seems undesirable that patients about to be subjected to the added stress of an anaesthetic and operation should come in such a physiological state. During operation there is a rise in the plasma glucose level in the normal adult but it has been shown that children do not respond with a hyperglycaemic reaction to the same degree (Watson, 1972;Clarke, 1970).…”

Section: Resultsmentioning

confidence: 99%

Preoperative plasma glucose level

Morrice¹,

Taylor²,

Blair³

et al. 1974

Archives of Disease in Childhood

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. (1974). Archives of Disease in Childhood, 49, 898. Preoperative plasma glucose level. The plasma glucose level of 25 infants and children who had routine preparation for anaesthesia and operation has been measured immediately after induction of anaesthesia. The mean plasma glucose level was 66 mg/100 ml. 5 patients had plasma glucose of 40 mg/100 ml or less. In a similar group in respect of age and weight a milk feed was given 4 hours before operation. The mean plasma glucose in the 20 patients in this group was 82 mg/100 ml and no patient had a plasma glucose of less than 60 mg/100 ml. No problems were encountered by giving the milk feed 4 hours before operation.To minimize the danger of vomiting and inhalation of vomit during induction or on recovery from general anaesthesia it is routine practice to ensure that the patient is presented for anaesthesia after a fast of at least 4 hours. The dangers of vomiting have been stressed so much that in most hospitals patients coming for anaesthesia have been starved for periods considerably in excess of 4 hours. This study was undertaken to determine the blood glucose levels in patients treated in the standard fashion of preoperative fasting and to compare this with a similar group of infants who had been given an oral milk feed 4 hours before operation. Patients and methodsPatients under 5 years of age who were admitted for relatively minor surgical procedures were studied. They were arbitrarily split into 2 groups. 25 patients Received 24 April 1974. (group A) were treated in the routine manner. On investigating the duration of the preoperative period of fasting in these patients it was found to vary from 6 hours to 12 hours and on one occasion was over 12 hours. 20 infants (group B) were prepared in the routine fashion but 4 hours before operation each was given a milk feed of 10 ml/kg up to a maximum of 300 ml. (This upper limit was agreed before starting the series, but none of the patients weighed enough to require this volume.) The basic information on the 2 groups is given in Table I. The mean age of group A was 21 -4 months compared with 17 * 2 months in group B, and the mean weight 10-77 kg and 10-72 kg, respectively. These differences are not statistically significant.Premedication was given as ordered by the anaesthetist and the patients taken to theatre. Anaesthesia was induced by inhalation of nitrous oxide, oxygen, and halothane. Whenever the patients were anaesthetized a capillary blood sample was taken by a finger or heel prick. All patients had a good peripheral circulation at the time the blood sample was taken. The plasma glucose level was measured using the glucose oxidase autoanalyser method (Morley, Dawson, and Marks, 1968). BLE IAge and weight and plasma glucose levels of patients in whom preoperative plasma glucose levels were studied: group A had standard preoperative care and group B were given milk 4 hours before operation Mean true glucose±SEM (and range) 66 1*13 7 (29-98) 82 1* ±3-4 (62-120) (mg/100 ml) *P <0 001 for difference...

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“…[7][8][9] However, prolonged fasting in children is known to cause hypoglycemia, with reports of fasting glucose as low as 10 mg/dL (0.56 mmol/L). 10,11 Finally the risk of clonidine unmasking a seizure disorder is questionable, supported by a single report. Seizures have not been reported as a part of clonidine overdose or as an adverse event from therapeutic use.…”

Section: Replymentioning

confidence: 99%

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Spiller¹

2006

The Journal of Pediatrics

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Blood Glucose Levels in Children During Surgery

Cited by 45 publications

References 2 publications

Perioperative blood glucose in a paediatric daycase facility: Effects of fasting and maintenance fluid

Perioperative blood glucose in a paediatric daycase facility: Effects of fasting and maintenance fluid

Preoperative plasma glucose level

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