Incidence and risk factors of intraoperative hyperglycemia in non-diabetic patients: a prospective observational study

Sermkasemsin, Varunya; Rungreungvanich, Mali; Apinyachon, Worapot; Sangasilpa, Inthuon; Srichot, Wanlee; Pisitsak, Chawika

doi:10.1186/s12871-022-01829-9

Cited by 6 publications

(3 citation statements)

References 25 publications

(32 reference statements)

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“…The majority of nondiabetic individuals undergoing moderate- to high-risk surgery experienced intraoperative hyperglycemia. Therefore, the risk factors for intraoperative hyperglycemia must be determined [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of Different Crystalloids on the Blood Glucose Levels of Nondiabetic Patients Undergoing Major Elective Surgeries

Kurra¹,

Madhusudhana²

2023

Cureus

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BackgroundThis study aimed to compare intraoperative blood sugar level fluctuations between a group of patients receiving Ringer's lactate (RL) fluid as maintenance fluid and another group receiving 0.45% dextrose normal saline with 20 mmol/liter potassium. Materials and methodsThis randomized double-blind study was conducted on 68 nondiabetic patients undergoing elective major surgeries at R. Laxminarayanappa Jalappa Hospital, Sri Devaraj Urs Medical College, Kolar, during the academic year from Jan 2021 to May 2022. Informed consent was obtained from these patients concerning their participation in this study. There were two groups of patients: Ringer lactate (RL) was administered to group A, and 0.45% dextrose normal saline and 20 mmol/L potassium chloride (KCl) were administered to group B. The vitals and blood glucose levels were measured among the patients. A p-value of 0.05 was considered statistically important. ResultsThe mean age of the patients was found to be 43.60 ± 15 years, with comparable age and gender distribution between the groups. On comparison of the mean blood glucose levels immediately after induction was not important between the groups. The mean levels were comparable between the groups (p>0.05). After completion of the surgery, the mean blood glucose level significantly increased in group B patients when compared to those in group A (p<0.05). ConclusionThe study found a substantial increase in intraoperative blood glucose levels among patients receiving 0.45% dextrose normal saline with 20 mmol/liter potassium instead of RL solution as maintenance fluid.

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Section: Discussionmentioning

confidence: 99%

Impact of Different Crystalloids on the Blood Glucose Levels of Nondiabetic Patients Undergoing Major Elective Surgeries

Kurra¹,

Madhusudhana²

2023

Cureus

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“…IR is characterized by transient and reversible hyperglycemia, a condition also known as stressful hyperglycemia [40,41]. Recent studies [42,43] have shown that the incidence of postoperative hyperglycemia ranges from 20-40% in patients undergoing non-cardiac surgery. The presence of stress hyperglycemia is often accompanied by perioperative morbidity and mortality, a higher risk of postoperative wound infection, and a longer length of hospital stay.…”

Section: Discussionmentioning

confidence: 99%

Index of consciousness monitoring during general anesthesia may effectively enhance rehabilitation in elderly patients undergoing laparoscopic urological surgery: a randomized controlled clinical trial

Liu

Wang

et al. 2023

Preprint

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Background Elderly patients are at a significantly higher risk of perioperative complications. Based on electroencephalogram (EEG) analysis, index of consciousness (IoC) monitoring is a new technique for monitoring anesthesia depth. IoC is divided into two parts: IoC1 (depth of sedation) and IoC2 (depth of analgesia). There have only been a few studies in which IoC1 and IoC2 are simultaneously monitored to speed up postoperative recovery. We investigated whether combined monitoring of IoC1 and IoC2 can effectively improve postoperative recovery in elderly patients undergoing laparoscopic urological surgery under general anesthesia. Methods A prospective, randomized, controlled, double-blind trial was carried out on elderly patients scheduled for laparoscopic urological surgery under total intravenous anesthesia. Patients were assigned to either the IoC group (n = 60) or control group (n = 60) at random. The prevalence of postoperative cognitive dysfunction (POCD) was the primary endpoint. Inflammatory markers, arterial blood gas analysis, postoperative complications, and length of hospital stay were among the secondary endpoints. Results The study included 120 patients with an average age of 71.20 ± 5.06 years. Compared to the control group, the incidence of POCD was significantly lower (19(31.7%) vs. 6(10%); P = 0.003), and serum C-reactive protein(CRP) and glial fibrillary acidic protein(GFAP) concentrations were lower at the end of surgery (CRP: 5.36 ± 3.36 vs. 3.11 ± 2.62; P = 0.000, GFAP: 3.29 ± 1.22 vs. 2.42 ± 1.38; P = 0.000) and 24h after surgery (CRP:11.75 ± 7.52 vs. 8.15 ± 5.24;P = 0.003, GFAP: 4.84 ± 1.20 vs. 3.96 ± 2.23; P = 0.008) in the IoC group. Blood glucose levels at the end of surgery (9.17 ± 2.04 vs. 7.11 ± 1.35; P = 0.000) and the total rate of complications at 7 days after surgery (16(26.7%) vs. 7(11.7%), P = 0.037) were significantly lower in the IoC group. Conclusion IoC monitoring for managing elderly surgical patients can hasten postoperative recovery by reducing intraoperative stress and the resulting systemic and neuroinflammation. TRIAL REGISTRATION: Chinese Clinical Trial Registry Identifier: ChiCTR1900025241（17/08/2019）.

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“…IR is characterized by transient and reversible hyperglycemia, a condition also known as stressful hyperglycemia [ 48 , 49 ]. Recent studies [ 50 , 51 ] have shown that the incidence of postoperative hyperglycemia ranges from 20 to 40% in patients undergoing non-cardiac surgery. The presence of stress hyperglycemia is often accompanied by perioperative morbidity and mortality, a higher risk of postoperative wound infection, and a longer length of hospital stay.…”

Section: Discussionmentioning

confidence: 99%

Index of consciousness monitoring during general anesthesia may effectively enhance rehabilitation in elderly patients undergoing laparoscopic urological surgery: a randomized controlled clinical trial

Qi,

Fan,

Wang

et al. 2023

BMC Anesthesiol

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Background Based on electroencephalogram (EEG) analysis, index of consciousness (IoC) monitoring is a new technique for monitoring anesthesia depth. IoC is divided into IoC1 (depth of sedation) and IoC2 (depth of analgesia). The potential for concurrent monitoring of IoC1 and IoC2 to expedite postoperative convalescence remains to be elucidated. We investigated whether combined monitoring of IoC1 and IoC2 can effectively enhances postoperative recovery compared with bispectral index (BIS) in elderly patients undergoing laparoscopic urological surgery under general anesthesia. Methods In this prospective, controlled, double-blinded trail, 120 patients aged 65 years or older were arbitrarily assigned to either the IoC group or the control group (BIS monitoring). All patients underwent blood gas analysis at T1 (before anesthesia induction) and T2 (the end of operation). The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were administered to all patients at T0 (1 day before surgery) and T4 (7 days after surgery). Serum concentrations of C-reactive protein (CRP) and glial fibrillary acid protein (GFAP) were assessed at T1, T2, and T3 (24 h after surgery). Postoperative complications and the duration of hospitalization were subjected to comparative evaluation. Results The incidence of postoperative cognitive dysfunction (POCD) was notably lower in the IoC group (10%) than in the control group (31.7%) (P = 0.003). Postoperative serum CRP and GFAP concentrations exhibited significant differences at time points T2 (CRP: P = 0.000; GFAP: P = 0.000) and T3 (CRP: P = 0.003; GFAP: P = 0.008). Postoperative blood glucose levels (P = 0.000) and the overall rate of complications (P = 0.037) were significantly lower in Group IoC than in Group control. Conclusion The employment of IoC monitoring for the management of elderly surgical patients can accelerate postoperative convalescence by mitigating intraoperative stress and reducing peripheral and central inflammatory injury. Trial registration Chinese Clinical Trial Registry Identifier: ChiCTR1900025241 (17/08/2019).

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Incidence and risk factors of intraoperative hyperglycemia in non-diabetic patients: a prospective observational study

Cited by 6 publications

References 25 publications

Impact of Different Crystalloids on the Blood Glucose Levels of Nondiabetic Patients Undergoing Major Elective Surgeries

Impact of Different Crystalloids on the Blood Glucose Levels of Nondiabetic Patients Undergoing Major Elective Surgeries

Index of consciousness monitoring during general anesthesia may effectively enhance rehabilitation in elderly patients undergoing laparoscopic urological surgery: a randomized controlled clinical trial

Index of consciousness monitoring during general anesthesia may effectively enhance rehabilitation in elderly patients undergoing laparoscopic urological surgery: a randomized controlled clinical trial

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