The effect of anti-emetic doses of dexamethasone on postoperative blood glucose levels in non-diabetic and diabetic patients: a prospective randomised controlled study

Abstract

SummaryThere are few data regarding postoperative hyperglycaemia in non-diabetic compared with diabetic patients following postoperative nausea and vomiting prophylaxis with dexamethasone. Eighty-five non-diabetic patients and patients with type-2 diabetes were randomly allocated to receive intravenous dexamethasone (8 mg) or ondansetron (4 mg). Blood glucose levels were measured at baseline and then 2, 4 and 24 h following induction of anaesthesia. In nondiabetic patients, the mean (SD) maximum blood glucose was higher in those who received dexamethasone compared with ondansetron (9.1 (2.2) mmol.l À1 vs. 7.8 (1.4) mmol.l À1

Artefactual ST elevation with Mindray monitors – manufacturer's reply

“…We thank Tien et al for their prospective randomised study on dexamethasone and blood glucose levels in diabetic and non-diabetic patients [1]. We would like to invite the authors to address several questions that we have.…”

“…) for patients administered low-flow anaesthesia using the formula: (inspired O 2 fractionÀend-tidal O 2 fraction) 9 minute ventilation [1], but we suggest that the alveolar minute ventilation, not the total minute ventilation, should be used for this calculation. Total minute ventilation includes dead-space ventilation, which does not take part in gas exchange.…”

Postoperative blood sugars and use of starches - a reply

“…Patel and Fregene for their interest in our study [1]. While some studies have reported an increase in blood glucose following the use of hetastarch [2], others did not show a difference in glucose concentrations between those who received hetastarch compared with lactated Ringers's [3] or with gelatin solutions [4].…”

“…Tien et al reported an increase in postoperative blood sugar levels after anti-emetic doses of dexamethasone were used in diabetic and non-diabetic patients [1].…”

“…It is important to note, however, that our study was not designed to address this question. [1]. Whilst one can see the attraction of standardising any safety critical endeavour, I believe the authors have gone beyond what is reasonable in the question of anaesthesia for hip fracture.…”