Perioperative Dexamethasone for Patients With Diabetes and Its Effect on Blood Glucose After Surgery

Bonilla, Jose L; Rodriguez-Torres, Jeanette B; Verar, Gilbert L; Mason-Nguyen, Jill; Moore, Chad

doi:10.1016/j.jopan.2021.10.005

Cited by 2 publications

(1 citation statement)

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“…showed peak glucose levels in the first 24 hours. [ 16 ] Our findings were different from both these studies. The blood glucose values performed 120 minutes after administration of dexamethasone/placebo were similar in both groups.…”

Section: Discussioncontrasting

confidence: 99%

Effect of a single intraoperative dose of dexamethasone on glycaemic profile in postoperative patients - A double-blind randomised controlled study

2022

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Background and Aims: The effect of a single intraoperative dose of steroids on perioperative blood sugar levels is uncertain. We hypothesised that a single dose of dexamethasone would not unfavourably alter the glucose levels of non-diabetic patients. This study aimed to evaluate the post-operative glycaemic profile after a single dose of intraoperative dexamethasone in non-diabetic patients. The presence of post-operative nausea and vomiting (PONV), pain, surgical site infection (SSI) and length of hospital stay were also evaluated. Methods: This randomised, double-blind, controlled study was done by recruiting 150 non-diabetic adult patients of the American Society of Anesthesiologists physical status I/II undergoing elective surgery. Patients in the study group were administered a single dose of dexamethasone (0.15 mg/kg). Blood glucose levels were assessed at various time points for up to 72 hours post-operatively using point-of-care testing. Secondary outcomes such as PONV, pain, fever and SSI were also documented. Data were compared and analysed using Student’s t-test, Chi-square test, Mann-Whitney test and analysis of variance test. Results: There was an earlier, higher and prolonged elevation in blood glucose levels in patients receiving dexamethasone. The mean (standard deviation) of fasting/postprandial blood sugars on the first, second and third postoperative days respectively was significantly higher in the study group 98.04 (21.89)/139.16 (20.59), 96.64 (19.20)/138.17 (18.05), 96.60 (17.40)/138.32 (15.10) mg/dl as compared to control group 86.9 6 (10.28)/128.95 (10.53), 88.81 (8.87)/131.97 (9.68), 88.16 (8.50)/130.88 (9.48) mg/dl. About 10.7% of the patients who received dexamethasone had blood glucose levels greater than 180 mg/dl. There were no significant differences in the secondary outcomes. Conclusion: Even a single dose of dexamethasone in non-diabetic adults causes significant and prolonged postoperative hyperglycaemia.

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Section: Discussioncontrasting

confidence: 99%