Perioperative management of hyperglycemic patients undergoing surgery: an observational cross sectional study in a tertiary care hospital

Namra A. Sayed, Yashashri Shetty, S. Salgaonkar
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Abstract

Background: Diabetes poses an additional risk during anesthesia, yet there is a lack of sufficient Indian data on perioperative antidiabetic drug use and its implications. This droves us to conduct the study. Methods: Cross-sectional, observational study, conducted in a tertiary care hospital's general surgery and orthopaedics wards. Data collected from the first anaesthetist visit to 24 hours postoperative period included antidiabetic medications, anesthesia drugs, blood sugar levels, co-morbidities, concomitant medications, and intravenous (IV) fluids. Descriptive statistics and parametric tests were used for analysis. Results: The study comprised 180 patients (62.8% males, median age 56 years), with diabetes duration predominantly between 1-5 years (28.3%). Preoperatively, metformin was the most prescribed oral hypoglycemic agent (72.2%), decreasing to 56.67% postoperatively. Intraoperatively, only 1.6% received insulin, while 98.4% received no drugs. Common postoperative antidiabetic agents included insulin BD (n=48). General surgery (73.3%) and orthopedics (26.7%) contributed 132 and 48 patients, respectively, with spinal anesthesia (68.3%) and bupivacaine (75.4%) being most prevalent. Blood glucose during surgery was effectively monitored. Hypertension (52.8%) was the most common co-morbidity, and Ringer lactate (60.8%) was the predominant IV fluid. Conclusions: Adequate perioperative antidiabetic management was observed in hyperglycemic patients.
接受外科手术的高血糖患者的围手术期管理:在一家三级护理医院进行的横断面观察研究
背景:糖尿病在麻醉过程中会带来额外的风险,但印度在围手术期抗糖尿病药物的使用及其影响方面缺乏足够的数据。这促使我们开展了这项研究:横断面观察研究,在一家三级医院的普通外科和骨科病房进行。从麻醉师首次就诊到术后 24 小时收集的数据包括抗糖尿病药物、麻醉药物、血糖水平、合并疾病、伴随药物和静脉注射液(IV)。采用描述性统计和参数检验进行分析:研究对象包括 180 名患者(62.8% 为男性,中位年龄 56 岁),糖尿病病程主要在 1-5 年之间(28.3%)。术前,二甲双胍是处方最多的口服降糖药(72.2%),术后降至 56.67%。术中,只有 1.6% 的患者使用了胰岛素,98.4% 的患者没有使用任何药物。常见的术后抗糖尿病药物包括胰岛素 BD(48 人)。普外科(73.3%)和骨科(26.7%)分别有 132 名和 48 名患者,其中以脊髓麻醉(68.3%)和布比卡因(75.4%)最为普遍。手术期间的血糖得到了有效监测。高血压(52.8%)是最常见的并发症,乳酸林格液(60.8%)是最主要的静脉注射液:结论:高血糖患者围手术期的抗糖尿病管理充分。
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