Anesth Essays Res. 2016 Sep-Dec;10(3):425-431. doi: 10.4103/0259-1162.176411.

Impact of different intravenous fluids on blood glucose levels in nondiabetic patients undergoing elective major noncardiac surgeries.

Anesthesia, essays and researches

Ranjana Khetarpal, Veena Chatrath, Jagjit Kaur, Anju Bala, Harjeet Singh

PMID: 27746527 PMCID: PMC5062227 DOI: 10.4103/0259-1162.176411

Abstract

BACKGROUND: Intravenous (IV) fluids are an integral part of perioperative management. Intraoperative hyperglycemia is associated with poor clinical outcomes in patients undergoing major surgeries even in nondiabetics.

AIM: This study was conducted to observe the effect of different maintenance fluid regimens on intraoperative blood glucose levels in nondiabetic patients undergoing major surgeries under general anesthesia.

SETTINGS AND DESIGN: Randomized double-blind study.

MATERIALS AND METHODS: One hundred nondiabetic patients of either sex were divided randomly into two Groups I and II of 50 each undergoing elective major surgeries of more than 90 min duration under general anesthesia. Both groups were given calculated dosage of IV fluids accordingly 4-2-1 formula while Group I was given Ringer lactate (RL) and Group II was given 0.45% dextrose normal saline and potassium chloride 20 mmol/L. Changes in vital parameters, % oxygen saturation, and urine output were monitored at regular intervals. Capillary blood glucose (CBG) was measured half-hourly until end of surgery. If CBG level was more than 150 mg%, then calculated dose of human insulin (CBG/100) was given as IV bolus dose.

STATISTICAL ANALYSIS: Statistical analysis was done using SPSS 22.0 software (IBM Corporation, Armonk, New York, USA), paired

RESULTS: A significant increase of CBG level and was observed during intraoperative and immediate postoperative period (

CONCLUSION: RL solution is probably the alternative choice of IV fluid for perioperative maintenance and can be used as replacement fluid in nondiabetic patients undergoing major surgeries.

Keywords: Double-blind method; Ringer's lactate; human; hyperglycemia; insulin; regular

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