TITLE:
Factors Associated with Increases in Glucose Levels in the Perioperative Period in Non-Diabetic Patients
AUTHORS:
Vasanti Tilak, Catherine Schoenberg, Alejandro F. Castro III, Manasee Sant
KEYWORDS:
Blood Glucose; Perioperative; Nondiabetic
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.3 No.3,
May
14,
2013
ABSTRACT: Background: Blood
glucose levels are elevated during the perioperative period as a result of the
neuro-endocrine response
to the stress of surgery. In nondiabetic patients, blood glucose levels are not
a part of routine preoperative testing nor are they monitored during surgery or
in the post anesthesia care unit (PACU). We measured blood glucose levels in
nondiabetic patients during the perioperative period to identify how many
patients had high glucose levels and what factors were associated with
increases in blood glucose levels. Methods: This prospective observational study included two hundred and ninety five
nondiabetic patients between the ages of 18 and 80 years, undergoing elective
noncardiac surgery. Blood glucose levels were measured preoperatively and at
frequent, predetermined intervals during surgery and in the PACU. Patient
characteristics, surgical and anesthetic factors, and pain scores in the PACU
were recorded, as were postoperative complications. Results: Forty
nine percent (49%) of the patients had maximum intraoperative glucose levels of 126 mg/dl or higher and
fifty three percent (53%) had maximum postoperative glucose levels of 126 mg/dl
or higher. Preoperative glucose levels, family history of diabetes and amount
of blood loss were statistically significantly associated with both max-intra-op and max-post-op glucose
levels. Additionally, blood administration, surgery duration and race were
significantly associated with max-intra-op glucose levels, while amount of
intravenous fluids
and sex were significantly associated with max-post-op glucose levels. Conclusion: A large number of nondiabetic patients in our study had maximum glucose
levels >126 mg/dl in the perioperative
period. Certain patient characteristics, as well as surgical/anesthetic factors, were
associated with increases in the glucose levels. More studies are indicated to
determine which patients may benefit from glucose monitoring in the
perioperative period.