Hyperglycemia assessment in the post-anesthesia care unit

Abstract

Background and objectives: Hyperglycemia in surgical patients may cause serious problems. Analyzing this complication in this scenario contributes to improve the management of these patients. The aim of this study was to evaluate the prevalence of hyperglycemia in the postanesthetic care unit (PACU) in non-diabetic patients undergoing elective surgery and analyze the possible risk factors associated with this complication. Methods: We evaluated non-diabetic patients undergoing elective surgeries and admitted in the PACU. Data were collected from medical records through precoded questionnaire. Hyperglycemia was considered when blood glucose was >120 mg.dL −1 . Patients with hyperglycemia were compared to normoglycemic ones to assess factors associated with the problem. We excluded patients with endocrine-metabolic disorders, diabetes, children under 18 years, body mass index (BMI) below 18 or above 35, pregnancy, postpartum or breastfeeding, history of drug use, and emergency surgeries. Results: We evaluated 837 patients. The mean age was 47.8 ± 16.1 years. The prevalence of hyperglycemia in the postoperative period was 26.4%. In multivariate analysis, age (OR = 1.031, 95% CI 1.017---1.045); BMI (OR = 1.052, 95% CI 1.005---1.101); duration of surgery (OR = 1.011, 95% CI 1.008---1.014), history of hypertension (OR = 1.620, 95% CI 1.053---2.493), and intraoperative use of corticosteroids (OR = 5.465, 95% CI 3.421---8.731) were independent risk factors for postoperative hyperglycemia. Conclusion: The prevalence of hyperglycemia was high in the PACU, and factors such as age, BMI, corticosteroids, blood pressure, and duration of surgery are strongly related to this complication. PALAVRAS-CHAVECirurgia eletiva; Hiperglicemia; Prevalência; Fatores de risco; Sala de recuperação anestésica Avaliação de hiperglicemia na sala de recuperação pós-anestésicaResumo Justificativa e objetivos: Hiperglicemia em pacientes cirúrgicos pode ocasionar graves problemas. Nesse contexto, analisar essa complicação contribui para o melhor manejo desses pacientes. O objetivo do estudo foi avaliar a prevalência de hiperglicemia na sala de recuperação pós-anestésica (SRPA) em pacientes não diabéticos submetidos a cirurgias eletivas e analisar os possíveis fatores de risco associados a essa complicação. Métodos: Foram avaliados pacientes não diabéticos submetidos a cirurgias eletivas e admitidos na SRPA. Os dados foram coletados dos prontuários por meio de questionário pré-codificado. Foi considerada hiperglicemia quando a glicemia era > 120 mg.dL −1 . Pacientes com hiperglicemia foram comparados com os normoglicêmicos para avaliar fatores associados ao problema. Foram excluídos os pacientes com distúrbios endócrino-metabólicos, diabéticos, menores de 18 anos, índice de massa corpórea (IMC) menor do que 18 ou maior do que 35, gestação, puerpério ou aleitamento materno, antecedente de uso de drogas e cirurgias de urgência. Resultados: Foram avaliados 837 pacientes. A média de idade foi 47,8 ± 16,1 anos. A prevalên-cia de hiperglicemia n...

Magnitude and associated factors of postoperative hyperglycemia among an adult nondiabetic patient who underwent surgery at 2 tertiary hospitals in Ethiopia

“…Administration of dexamethasone during the intraoperative period is another factor associated with the likelihood of exhibiting postoperative hyperglycemia. This finding is consistent with the study reported by Pereira et al [11] . The administration of 8 mg of dexamethasone between diabetic and nondiabetic patients who underwent laparoscopic surgery, the BG levels observed at the 30 and 120 minutes marks were statistically significant relative to the preinduction BG [27] .…”

“…Our study found a high glucose level compared with a study conducted by Pereira et al11 (BG >120 mg/dL), 26.4%, according to Kwon et al12 (BG>180 mg/dL), 29.1% and a study reported by Jämsen et al13 (BG >140 mg/dL) 41%. The magnitude of the current findings is lower than the study reported by Ghildiyal et al14 (BG >140 mg/dL) 56.4% and at Singapore general hospital15 (BG >180 mg/dL) 56.1%.…”

Variación de niveles de glicemia perioperatoria en pacientes no diabéticas sometidas a cirugía gineco obstétrica

“…La hiperglucemia se presenta en un 26,4% en la sala de recuperación posanestésica, y factores como la edad, duración de la cirugía, historia de hipertensión y uso intraoperatorio de corticosteroides están fuertemente relacionados con esa complicación (14). El presente estudio, local, determina la variación de glicemia perioperatoria comparando la técnica anestésica general versus la neuroaxial (peridural o raquídea).…”

Comparative Study of Children's' Blood Sugar in Fluid Therapy with Dextrose Saline, Ringer and Normal Saline 9.0% Serums and its Relationship with Depth of Anesthesia in Elective Surgery

“…In this regard, Pereira et.al in a study aimed at identifying risk factors for postoperative hyperglycemia, showed that hyperglycemia occurs severely in the recovery and factors such as age, BMI [2], corticosteroids, blood pressure and uids received during the operation play an important role in this increase (19). Regarding that changes in blood sugar affect brain metabolism and its function, evaluation of brain function during anesthesia has been considered as a monitoring method and based on this, parameters such as Bispectral Index, Audiutory Evoked Potential Index and Patient State Index were evaluated (20)(21)(22)(23).…”