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      • Record: found
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      Comparing the effects of general anesthesia and spinal anesthesia on the serum level of blood sugar in patients undergoing cesarean

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          Abstract

          Objective

          This paper aims to study the influence of both general and spinal anesthesia on blood sugar changes in patients undergoing cesarean.

          Methods

          This is a single-blind clinical trial study conducted on 60 patients with classes 1 and 2 anesthesia. The patients were divided by chance into the general anesthesia and spinal anesthesia groups (each contains 30 members). The patients in the spinal group were blocked up to the T4 level and similar methods and medicines were also utilized for those in the general anesthesia group.

          Results

          No significant difference was observed in the blood sugar levels of both groups before and after the operation, but the group, which had utilized the general anesthesia method, had reported with lower levels of blood sugar than the spinal anesthesia group after operation with a significant difference ( P < 0.05). A difference has been observed in the levels of blood sugar at 2, 12, and 24 h after the operation in both groups, but it was not a statistically significant difference.

          Conclusion

          However, none of the mentioned methods had any influence on reduction of blood sugar levels during the recovery or the period after it.

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          Most cited references28

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          Glucose homeostasis and insulin secretion during isoflurane anesthesia in humans.

          F Camu, M Diltoer (1988)
          The effect of isoflurane-air anesthesia on glucose tolerance in humans was investigated using two successive intravenous glucose tolerance tests (IVGTT). After a first IVGTT while awake, patients received a second IVGTT either while awake (group I), during anesthesia with isoflurane-air and pancuronium without surgical stimulation (group II), or during the same anesthetic technique but combined with surgery (group III). Isoflurane seemed to induce glucose intolerance (glucose disappearance rate K10-60 min = 1.628 +/- 0.462% min-1 [control] versus 1.086 +/- 0.920% min-1 [anesthesia], P less than 0.05) partly due to a decreased glucose induced insulin response. Growth hormone and norepinephrine levels were also increased during anesthesia. Epinephrine levels were lowered by isoflurane anesthesia. Although glucose intolerance was marked during surgery (K10-60 min = 0.892 +/- 0.286% min-1), the glucose-induced insulin response remained similar to that observed in patients in group II, while growth hormone, cortisol, epinephrine, and norepinephrine concentrations increased significantly. These known stress factors thus seemed to enhance glucose intolerance through a diminished response to insulin action and/or an enhanced hepatic glucose output, rather than by further impairing pancreatic insulin secretion.
          Article 0 comments Cited 19 times – based on 0 reviews     Review now
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            Early post-operative glucose levels are an independent risk factor for infection after peripheral vascular surgery. A retrospective study.

            Titia M Vriesendorp, D Legemate, Joost Hoekstra … (2004)
            To evaluate whether hyperglycaemia in the first 48 h after infrainguinal vascular surgery is a risk factor for post-operative infection, independent from factors associated with insulin resistance and surgical stress. Retrospective cohort study. Patients who underwent infrainguinal vascular surgery in our hospital between March 1998 and March 2003 were included. Glucose values until 48 h after surgery were retrieved from laboratory reports. Post-operative infections, treated with antibiotics, during hospital stay were scored until 30 days after surgery. Data were analysed with univariate and multivariate logistic regression analyses. At least one post-operative glucose value was retrieved for 211/275 (77%) patients. The incidence of post-operative infections was 84/275 (31%). When corrected for factors associated with insulin resistance and surgical stress, post-operative glucose levels were found to be an independent risk factor for post-operative infections (odds ratio top quartile versus lowest quartile: 5.1; 95% confidence interval: 1.6-17.1; P=0.007). Post-operative glucose levels appear to be an independent risk factor for infections after infrainguinal vascular surgery. This finding requires confirmation in a prospective study.
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              Alterations in protein, carbohydrate, and fat metabolism in injured and septic patients.

              D Wilmore (1982)
              The physiological and biochemical responses of the body following major injury or severe infection are characterized by hypermetabolism, accelerated gluconeogenesis, and the mobilization of substrates from the carcass to be utilized by visceral organs. These responses in the febrile patient are supported by an elevated cardiac output which insures perfusion of vital organs and provides additional bloodflow to the area of inflammation and/or injury. Because of the accelerated substrate flux and increased catabolism, weight loss and negative nitrogen balance are profound. Cumulative losses rapidly approach near-lethal limits if adequate nutritional support is not instituted. Nutritional maintenance will support the febrile response, maintain body nitrogen and acute phase protein synthesis, and assure an ongoing energy supply. Reparative tissue appears to preferentially utilize substrate, but if malnutrition occurs, wound healing and tissue repair may be limited. The effects of nutritional support on immunological function in these critically ill patients are only now being dissected. Clearly, immunosuppression is related to the initial insult and abnormalities in host defense mechanisms occur almost immediately in patients well nourished before illness. In addition, nutrient depletion and erosion of body mass are also associated with immunological dysfunction so that these two factors combine to impair the patient's resistance to subsequent infection. Present therapy should maintain balance of essential nutrients while complications associated with specialized techniques of nutrient support are minimized. Control of the patient's environment, minimizing pain and discomfort, preventing "bad rest" effect through exercise are all techniques of supportive care, but responses are ablated with resolution of the infection or wound closure, and every effort should be directed toward this goal.
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                Author and article information

                Journal
                Journal ID (pmc): imas
                Journal ID (publisher-id): IMAS
                Title: Interventional Medicine and Applied Science
                Abbreviated Title: IMAS
                Publisher: Akadémiai Kiadó (Budapest )
                ISSN (Print): 2061-1617
                ISSN (Electronic): 2061-5094
                Publication date (Electronic, epub): 09 April 2018
                Publication date (Print, ppub): December 2018
                Volume: 10
                Issue: 4
                Pages: 202-206
                Affiliations
                [ 1 ]Faculty of Medicine, Department of Pediatrics, Birjand University of Medical Sciences , Birjand, Iran
                [ 2 ]Department of Anesthesia, Birjand University of Medical Sciences , Birjand, Iran
                [ 3 ]Faculty of Medicine, Department of Anesthesia, Birjand University of Medical Sciences , Birjand, Iran
                Author notes
                [* ]Corresponding author: Amir Saber Tanha; Faculty of Medicine, Department of Anesthesia, Birjand University of Medical Sciences, 2nd floor, No. 64, Bahonar Sharghi Ave, Pasdaran Ave, Birjand, Iran; Phone: +98 91 5160 0384; Fax: +98 56 3243 2778; E-mail: dr.saber@ 123456bums.ac.ir
                Article
                DOI: 10.1556/1646.10.2018.17
                PMC ID: 6376357
                SO-VID: b368c159-396a-4b71-b4aa-846d8793c545
                Copyright © © 2018 The Author(s)
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

                History
                Date received : 04 February 2018
                Date accepted : 05 March 2018
                Page count
                Figures: 0, Tables: 3, Equations: 0, References: 24, Pages: 5
                Funding
                Funding sources: Funding was provided by Birjand University of Medical Sciences.
                Categories
                Subject: ORIGINAL PAPER

                ScienceOpen disciplines: Medicine,Immunology,Health & Social care,Microbiology & Virology,Infectious disease & Microbiology
                Keywords: spinal anesthesia,blood,glucose,cesarean,general anesthesia,serum level
                Data availability:
                ScienceOpen disciplines: Medicine, Immunology, Health & Social care, Microbiology & Virology, Infectious disease & Microbiology
                Keywords: spinal anesthesia, blood, glucose, cesarean, general anesthesia, serum level

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