Glucose for children during surgery: Pros, cons, and protocols: A postgraduate educational review

Datta, Priyankar Kumar; Aravindan, Ajisha

doi:10.4103/aer.aer_39_17

Cited by 19 publications

(19 citation statements)

References 37 publications

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“…Hypoglycemia was defined as RBS <70 mg/dL[ 4 ] and hyperglycemia as RBS >150 mg/dL. [ 5 ] If the RBS was below 70 mg/dL in either of the groups at any point during the study, 2.5 mL/kg of 10% dextrose was administered intravenously (IV) as a bolus to correct hypoglycemia and these patients were excluded from the study.…”

Section: Methodsmentioning

confidence: 99%

Is intraoperative supplementation of dextrose essential for infants undergoing facial cleft surgeries?

Rajan

Barua

Tosh

et al. 2020

J Anaesthesiol Clin Pharmacol

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Background and Aims: Dextrose is commonly added to the intraoperative maintenance fluids of pediatric patients. The primary objective was to evaluate the effect of addition of 1% dextrose to Ringer's lactate (RL) on blood glucose levels in infants undergoing facial cleft surgeries. Material and Methods: This prospective, randomized, single blinded study was conducted in forty infants undergoing either cheiloplasty or palatoplasty. Random blood sugar (RBS) was assessed using a glucometer after induction of anaesthesia, and at 1 and 2 hours later. Group R received RL and Group D received RL with 1% dextrose as intraoperative maintenance fluid. Hypoglycemia was defined as RBS <70 mg/dL and hyperglycemia as RBS >150 mg/dL. Results: Baseline RBS levels and those at 60 min and 120 min post-induction were comparable in both groups. The increase in blood sugar levels from baseline to 60 min and to 120 min in each group was significant. Incidence of hyperglycemia was comparable in both groups. There were no episodes of hypoglycemia, intraoperatively. Conclusion: Use of Ringer lactate alone or with addition of 1% dextrose resulted in comparable intraoperative blood sugar levels when used as maintenance fluid in infants undergoing facial cleft surgeries.

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Section: Methodsmentioning

confidence: 99%

Is intraoperative supplementation of dextrose essential for infants undergoing facial cleft surgeries?

Rajan

Barua

Tosh

et al. 2020

J Anaesthesiol Clin Pharmacol

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“…Serum glucose levels before anesthesia depend on various factors, including age, duration of fasting, and type of premedication. However, the effect of the mentioned factors on the preoperative serum glucose level is still in debate [9]. Age and body weight of children are considered important factors that influence serum glucose levels [10].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Preoperative Fasting Duration on Blood Glucose and Hemodynamics in Children

Hajian

Shabani

Khanlarzadeh

et al. 2020

Journal of Diabetes Research

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Background. Prolonged preoperative fasting is one of the concerns of pediatricians and anesthesiologists in pediatric surgery. The aim of this study was to assess the impact of preoperative fasting duration on blood glucose and hemodynamics in children. Methods. This cross-sectional study was conducted on 50 children who were between the ages of 3 and 12 years in Besat Hospital, Hamedan, Iran. The time of the last solid and liquid meal taken by child were recorded based on interview with the parents. The first blood glucose test was obtained in the operation room, and the second test was performed 20 minutes after induction of anesthesia by glucometer. Systolic blood pressure (SBP), mean arterial pressure (MAP), and heart rate (HR) were recorded before anesthesia induction and in five-minute intervals in the first 20 minutes of surgery. Results. The mean age of the children was 6.63 (SD 1.85) years. Mean blood glucose 20 minutes after surgery was 101.17 (SD 92) mg/dl, which was significantly higher than the baseline values (87.66 (SD 11.84) mg/dl) (P<0.001). The comparison of mean blood glucose level between groups of fasting with different duration for solids (<12 hours and >12 hours) and for liquids (<6 hours and >6 hours) revealed no significant difference in either groups (P>0.05). No significant correlation was observed between blood glucose level at the induction of anesthesia with weight and age (P>0.05). There was a significantly negative correlation between duration of fasting for liquids and SBP (P>0.05). Conclusion. Prolonged preoperative fasting cannot affect blood glucose in children; however, maybe it has impact on systolic blood pressure.

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“…Datta and Aravindan[ 6 ] in a review study on neonates, had advocated the use of 1%–2.5% dextrose, but patient population constituted of neonates, and thus, the data could not be extrapolated to the age group of 1 month to 1 year that we analyzed in the present study.…”

Section: Discussionmentioning

confidence: 98%

“…These patients should be given dextrose-containing solutions or have their blood glucose monitored during surgery. [ 6 ]…”

Section: Discussionmentioning

confidence: 99%

“…Hypoglycemia was defined as blood sugar <70 mg/dL[ 5 ] and hyperglycemia as blood sugar >150 mg/dL. [ 6 ] At any point during the study, in both the groups, if the blood sugar reading was below 70 mg/dL, 25% dextrose at 1 mL/kg, double diluted with saline, was administered IV as a bolus to correct hypoglycemia. The fluid was administered according to body weight based on Holliday and Segar formula.…”

Section: S Ubjects and M Ethodsmentioning

confidence: 99%

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Effect of using ringer's lactate, with and without addition of dextrose, on intra-operative blood sugar levels in infants undergoing facial cleft surgeries

et al. 2018

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Background:Addition of glucose in the intraoperative fluid is a routine practice in infants. Under general anesthesia, due to neuroendocrine stress response, this could result in overt hyperglycemia.Aims:The aim of this study was to find whether the addition of 2% dextrose to Ringer's lactate (RL) caused hyperglycemia compared to no addition of dextrose to RL.Settings and Designs:This prospective randomized study was conducted in 100 infants undergoing facial cleft surgery at a tertiary care institution.Subjects and Methods:Group D received RL with 2% dextrose and Group R received RL without the addition of dextrose. Blood sugars were measured at induction, 1 h and 2 h later. Hyperglycemia was defined as blood sugar >150 mg/dL and hypoglycemia as <70 mg/dL.Statistical Analysis Used:Pearson's Chi-square test, Paired t-test, Mann–Whitney test, and Independent sample t-test were used as applicable.Results:Baseline blood sugar was comparable in both groups. A significant increase in blood sugar values from baseline was seen in both groups, but the increase was significantly more in Group D at 60 min (136.5 ± 41.9 vs. 109.2 ± 20.5) and at 120 min (150.1 ± 45.5 vs. 123.1 ± 31.7). The incidence of hyperglycemia was 50% in Group D and 12% in Group R. No patient developed hypoglycemia intraoperatively. No significant correlation between blood sugar and hours of fasting was established.Conclusion:Routine addition of dextrose to RL is not essential during short surgeries under general anesthesia in infants, provided preinduction blood sugar level is >70 mg/dL and intraoperative sugars are periodically monitored.

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Glucose for children during surgery: Pros, cons, and protocols: A postgraduate educational review

Cited by 19 publications

References 37 publications

Is intraoperative supplementation of dextrose essential for infants undergoing facial cleft surgeries?

Is intraoperative supplementation of dextrose essential for infants undergoing facial cleft surgeries?

The Impact of Preoperative Fasting Duration on Blood Glucose and Hemodynamics in Children

Effect of using ringer's lactate, with and without addition of dextrose, on intra-operative blood sugar levels in infants undergoing facial cleft surgeries

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