The Effect of Single Intraoperative Dose of Dexamethasone on the Blood Glucose Concentration in Diabetic and Non-Diabetic Patients: A Double Blinded Randomized Control Study.

Abstract

Background: Dexamethasone is widely used in anesthesia practise as prophylaxis for postoperative nausea and vomiting (PONV). Our aims were to evaluate the postoperative glycemic profile after a single dose of intraoperative dexamethasone in non-diabetic and diabetic patients and to evaluate the PONV.

Methods: This double-blinded, randomized, controlled study was done for 6 months from June to December 2024 in a tertiary care hospital after obtaining ethical committee clearance and CTRI registration. Patients were allocated to one of four groups: nondiabetics receiving saline, nondiabetics receiving dexamethasone, diabetics receiving saline, and diabetics receiving dexamethasone. The study drug or saline control was administered at the induction of anesthesia. Blood sugar values, two hours after dexamethasone/placebo administration as well as fasting blood sugar and postprandial blood sugar on postoperative day 1, 2 were taken as primary endpoints. PONV was assessed in the first 24 hours after surgery.

Results: The rise in blood glucose levels was higher in the group receiving dexamethasone compared to saline in both diabetics and nondiabetics (P < 0.05). None of the patients had blood glucose values more than 180 mg/dL after 2 hours and 8 hours of dexamethasone administration.

Conclusions: Dexamethasone can be considered as prophylaxis for PONV in well controlled diabetics and nondiabetics despite the increase in blood glucose levels as a hyperglycemic response (blood glucose value 180 mg/dL) to a single dose was not observed in our study.