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KMID : 0381219920240020213
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Journal of RIMSK
1992 Volume.24 No. 2 p.213 ~ p.219
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Changes of Blood Sugar Level According to Anesthetic methods
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Abstract
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Diabetes mellitus is the endocrine disease characterized by impariment of carbohydrate metabolism due to deficiency of insulin activity which leads to hyperglycemia and glycosuria.
The incidence of surgical treatment of the diabetic patients is gradually increasing because of their prolonged life span with development of modern therapeutic methods and their predisposition to conditions requiring surgical intervention.
The most important aspect of anesthetic management of diabetic patients to maintain the glucose homeostasis. Hyperglycemia may be exacerbated during surgery under general anesthesia with volatile lipuid anesthetics because of changes in
sympathetic
tone, increase in glucagon or corticosteroid level, etc.
Regional anesthesia may block the part of the metabolic stress response during surgery, probably by blocking of the neural communication from the surgical field.
We3 attempted to investigate the effects of anesthetics or anesthetic methods on sequential changes of blood sugar level.
We selected nondiabetic 45 patients who took the elective surgery during 6 months on sequential changes of blood surgar level. We selected nondiabetic 45 patients who took the elective surgery during 6 months from October 1991 to to march 1992.
They were divided into 4 subgroups such as 13 cases of halothane anesthesia, 13 cases of enflurane anesthesia. 13 cases of balanced anesthesia with fentanyl and diazepam, and 6 cases of spinal anesthesia.
We measured the blood sugar level in preoperative fasting state(control value), in intrapoperative 30, 60, 90 and 120 minutes and in30 and 60 minutes postoperatively.
@ES The results were as follows:
@EN 1) There were no sequential changes of blood sugar level compared with control value in halothane anesthesia and balanced anesthesia perioperatively.
2) the perioperative blood sugar level in enflurane anesthesia had significantly decreasing tendency with fluctuating pattern compared with control value.
3) The perioperative blood sugar level in spinal anesthesia had significantly decreasing tendency with stable pattern compared with control value.
Conclusively perioperative blood sugar levels may be slightly influenced by anesthetics or anesthetic methods, but the more important thing in the perioperative management of diabetic patients is suggested to measure the blood surgar level
periodically
and to maintain the permissible ranges of blood sugar levels by controlling the hyperglycemia or hypoglycemia with regular insulin or glucose, respectively.
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