Abnormal blood glucose levels alter the course and result of surgery. This study aims to quantify the incidence of hypoglycemia or hyperglycemia in the preoperative period and to assess the impact of duration of nil per os (NPO), age, intravenous fluids (IVFs), blood transfusion, severity of pain and anxiety, and steroid or antibiotic administration on preoperative blood glucose levels in nondiabetic patients.
Materials and methods
The NPO duration, age, IVF, blood transfusion, pain and anxiety score, steroid and antibiotic administration were noted in 1,000 nondiabetic patients presenting for both elective and emergency surgery. Blood glucose level was measured before induction of anesthesia by capillary finger-prick method. The values of blood glucose levels were analyzed for correlation with above-mentioned parameters.
Overall incidence of hypoglycemia was found to be 23.3%. About 27.2% of patients including 34.95% children posted for elective surgery and 33.37% of patients including 8.73% children posted for emergency surgery group were hypoglycemic. The incidence of hyperglycemia was 1.51 and 1.08% for adults in elective and emergency category respectively. Age showed widely varied association to preoperative blood glucose levels; blood glucose levels increased with age in male patients, with patients aged between 18 and 40 years admitted for emergency surgery (p = 0.006), but decreased with age in patients older than 60 years irrespective of gender and type of surgery (p = 0.014). The preoperative blood glucose levels increased with higher preoperative pain and anxiety (p = 0.05) and administration of steroids (p = 0.00043). Similarly, with increase in duration of NPO, preoperative blood glucose levels decreased in adult females (p = 0.000) and males over 40 years (p = 0.049), both admitted for emergency surgery. Only preoperative normal saline (NS; p = 0.001), 6% hydroxyethyl starch (HES; p = 0.043), Isolyte P (p = 0.000), and blood transfusion (p = 0.05) showed significant correlation.
Preoperative blood glucose monitoring is recommended mandatorily for all patients posted for emergency surgery. It is also recommended for elective pediatric and geriatric surgery patients, patients with high anxiety and/or pain, increased NPO duration, and preoperative administration of steroid, NS, 6% HES, or blood.
How to cite this article
Pattajoshi S, Nerurkar AA, Tendolkar BA. A Cross-sectional Observational Analysis of Preoperative Blood Glucose Levels in Nondiabetic Patients presenting for Surgery. Res Inno in Anesth 2017;2(2):29-33.