Comparison of Effects of Propofol and Enflurane on Blood Glucose Level

Jeong, Jee Seop; Oh, Soo Won; Koo, Gill Hoi

doi:10.4097/kjae.1998.34.2.323

Cited by 3 publications

(3 citation statements)

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“…[ 4 ] In another trial comparing effects of sevoflurane and propofol anesthesia, the results indicated that blood glucose levels were higher in the sevoflurane group. [ 7 ] In spite of several prospective trials reporting lower blood glucose levels during propofol anesthesia in comparison to volatile anesthesia, a blanket recommendation of propofol anesthesia over inhalational anesthetic agents based on ours and previous studies on different surgeries to maintain perioperative glycemic control remains controversial because of factors such as varying nature of surgical stimulation during different stages of surgery,[ 19 ] maintenance of euglycemia irrespective of anesthetic, or lack of glucose data in the postoperative period (<72 h),[ 12 20 ] which is an important contributor to hyperglycemia-induced complications in surgical patients.…”

Section: Discussionmentioning

confidence: 99%

Randomized trial to compare plasma glucose trends in patients undergoing surgery for supratentorial gliomas under maintenance of sevoflurane, desflurane, and propofol

et al. 2020

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Background: Anesthetic agents influence the glycemic response by affecting the neuroendocrine surgical response or directly modifying pancreatic insulin release. Due to chances of neuronal damage, intraoperative hyperglycemia and hypoglycemia both are detrimental for patients undergoing neurosurgeries. Inhalational (sevoflurane and desflurane) and intravenous (propofol) agents have been found to raise intraoperative glucose levels in nonneurological surgeries. Aim: We aimed to compare the intraoperative glucose levels in supratentorial glioma surgeries under the maintenance of three anesthetic agents such as sevoflurane, desflurane, and propofol. Materials and Methods: This randomized trial was conducted with 90 nondiabetic adults with supratentorial glioma. Thirty patients were allocated randomly to the three groups receiving sevoflurane, desflurane, and propofol. Baseline and hourly plasma glucose levels were recorded. Postoperatively, the time required to achieve an Aldrete score of 9 and complications were assessed. Results: Baseline plasma glucose levels were 111.23 ± 11.67, 109.47 ± 19.75, and 111.7 ± 13.88 mg/dL ( P = 0.84) in sevoflurance, desflurane, and propofol group, respectively. All of them showed an elevation of plasma glucose in relation to the time of surgery with variable trends. In the 4 th and 5 th h, the elevations in the inhalational groups (sevoflurane and desflurane) were significantly higher than the propofol group ( P = 0.003 and 0.002, respectively). The time for achieving Aldrete's score of 9 was higher in the propofol group ( P < 0.0001). No differences were observed in the duration of hospital stay or complications. Conclusions: Maintenance of anesthesia in nondiabetic patients showed clinically modest rise of plasma glucose which is higher in patients under sevoflurane and desflurane than under propofol. However, the immediate recovery was faster with inhalational agents compared to propofol-based anesthesia.

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Section: Discussionmentioning

confidence: 99%

Randomized trial to compare plasma glucose trends in patients undergoing surgery for supratentorial gliomas under maintenance of sevoflurane, desflurane, and propofol

et al. 2020

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“…In few human studies the effect of propofol on blood glucose during surgery was evaluated. Jeong et al [ 21 ] studied on the effect of propofol and enflurane on blood glucose. This study showed that propofol maintains normoglycemia during surgery compared to enflurane.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Propofol and Isoflurane on Blood Glucose during Abdominal Hysterectomy in Diabetic Patients

et al. 2014

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BackgroundAcute hyperglycemia in the perioperative period is associated with significantly increased complications. In few human studies the effects of propofol and inhalational anesthetic on the glucose metabolism were compared. In this study we evaluated the effect of propofol and isoflurane on blood glucose during abdominal hysterectomy in diabetic patients.MethodsAfter approval by the Ethical Committee and written informed consent, thirty 35 to 65 years old diabetic women underwent for elective abdominal hysterectomy under general anesthesia were studied in this randomized single blind clinical trial study. The plasma glucose was maintained at 100 to 180 mg/dL during the operation. Anesthesia protocol was similar in two groups except maintenance of anesthesia that was with infusion of propofol in the propofol group and with isoflurane in the isoflurane group. Blood glucose level and the rate of insulin intake during surgery compared between two groups.ResultsMean blood glucose before induction of anesthesia did not have significant difference between two groups, but 60 and 90 minutes after starting the operation blood glucose in the propofol group was significantly lower than isoflurane group. Also with using Repeated Measure test, two groups was significantly different according to blood glucose (P=0.045). Mean of administration of insulin during the surgery did not have significant difference between two groups by using repeated measure test and P=0.271. Also mean of bispectral index in different times during the surgery between two groups didn't have significant difference (P=0.35 repeated measure test).ConclusionBlood glucose increased during maintenance of anesthesia with isoflurane compared to propofol during the surgery.

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“…However, the use of higher fentanyl doses during propofol anesthesia than sevoflurane anesthesia, the existence of various degrees of surgical stimulation, and the lack of anesthetic depth monitoring during surgery, may have obscured the lower glucose levels during propofol anesthesia compared with sevoflurane anesthesia in their retrospective study. Although several prospective studies have also reported lower blood glucose levels during propofol anesthesia versus volatile anesthesia, the clinical benefit of anesthetic choice on perioperative glycemic control remains controversial due to the absence of surgical stimulation [21], maintenance of euglycemia irrespective of anesthetic, or lack of glucose data from PODs (<72 hours) [17,25-27], which is an important contributor to hyperglycemia-induced complications in surgical patients [24,25].…”

Section: Discussionmentioning

confidence: 99%

Comparison of sevoflurane and propofol anesthesia on the incidence of hyperglycemia in patients with type 2 diabetes undergoing lung surgery

Kim

Han

Jung

et al. 2018

Yeungnam Univ J Med

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BackgroundThe type and regimen of anesthesia may affect perioperative hyperglycemia following major surgical stress. This study compared the effects of sevoflurane and propofol on the incidence of hyperglycemia and clinical outcomes in diabetic patients undergoing lung surgery.MethodsThis retrospective study included 176 patients with type 2 diabetes mellitus who had undergone lung surgery. Blood glucose levels and clinical outcomes from the preoperative period to the first 2 post-operative days (PODs) were retrospectively examined in patients who received sevoflurane (group S, n= 87) and propofol (group P, n=89) for maintenance of general anesthesia. The primary endpoint was the incidence of persistent hyperglycemia (2 consecutive blood glucose levels >180 mg/dL [10.0 mmol/L]) during the perioperative period. The secondary composite endpoint was the incidence of major postoperative complications and 30-day mortality rate after surgery.ResultsBlood glucose levels similarly increased from the preoperative period to the second POD in both groups (p=0.857). Although blood glucose levels at 2 hours after surgery were significantly lower in group P than in group S (p=0.022; 95% confidence interval for mean difference, -27.154 to -2.090), there was no difference in the incidence of persistent hyperglycemia during the perioperative period (group S, 70%; group P, 69%; p=0.816). The composite of major postoperative complications and all-cause in-hospital and 30-day mortality rates were also comparable between the two groups.ConclusionSevoflurane and propofol were associated with a comparable incidence of perioperative hyperglycemia and clinical outcomes in diabetic patients undergoing lung surgery.

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Comparison of Effects of Propofol and Enflurane on Blood Glucose Level

Cited by 3 publications

References 0 publications

Randomized trial to compare plasma glucose trends in patients undergoing surgery for supratentorial gliomas under maintenance of sevoflurane, desflurane, and propofol

Randomized trial to compare plasma glucose trends in patients undergoing surgery for supratentorial gliomas under maintenance of sevoflurane, desflurane, and propofol

The Effects of Propofol and Isoflurane on Blood Glucose during Abdominal Hysterectomy in Diabetic Patients

Comparison of sevoflurane and propofol anesthesia on the incidence of hyperglycemia in patients with type 2 diabetes undergoing lung surgery

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