A Cross Sectional Observational Study of Pre-operative and Intra-operative dysglycemia in adult patients undergoing elective Surgical Procedure at Sher-i-Kashmir Institute of Medical Sciences (SKIMS) Soura.

Abstract

Background: Fasting blood glucose is generally 70–100 mg/dl and after meals, it is 70–140 mg/dl.*These levels are maintained in the body via various metabolic pathways (gluconeogenesis, glycogenesis and glycogenolysis). Long fasting hours, drugs, various co-morbid conditions and stress can alter these levels.

Aims and Objectives

1. To find the prevalence of dysglycemia at the time of induction of anaesthesia and intra-operative period in adult patients undergoing various elective surgical procedures.
2. To assess the impact of duration of pre-operative fasting, and duration of surgery on pre-operative and intra-operative dysglycemia respectively.

Study Design; Cross-sectional observation study.

Participants; 668 patients of either sex above the age of 18 years undergoing various elective surgical procedures were included. Pregnant patients were excluded.

Methods: The number of hours that the patient had remained fasting (NPO) in the pre-operative period was observed and noted down. Blood glucose levels were measured by the glucometer just before the induction of anaesthesia, then intra-operatively at 90-minute intervals and at the end of surgery by the capillary finger-prick method.

Results: The prevalence of Pre-operative dysglycemia (hypoglycemia + hyperglycemia) in our study population was 30.3%  (17.7+12.6) and the prevalence of Intra-operative dysglycemia was 12.3% (2.1+10.2).

Conclusion: The duration of pre-operative fasting hours had a significant effect on pre-operative hypoglycemia. As the duration of fasting increased the prevalence of hypoglycemia also increased. Similarly, there was a significant effect of the duration of surgery on the intraoperative hyperglycemia. More the duration of surgery more was the prevalence of intra-op hyperglycemia.

Implications: Excessive pre-operative fastings hours should be avoided.

Intraoperative blood sugar should be measured especially in long surgeries.