Effect of Using Ringer's Lactate, with and without Addition of Dextrose, on Intra-Operative Blood Sugar Levels in Infants Undergoing Facial Cleft Surgeries

Kaushik Barua, Sunil Rajan, Jerry Paul, Pulak Tosh, Anju Padmalayan, Lakshmi Kumar, Kaushik Barua, Sunil Rajan, Jerry Paul, Pulak Tosh, Anju Padmalayan, Lakshmi Kumar

Abstract

Background: Addition of glucose in the intraoperative fluid is a routine practice in infants. Under general anesthesia, due to neuroendocrine stress response, this could result in overt hyperglycemia.

Aims: The aim of this study was to find whether the addition of 2% dextrose to Ringer's lactate (RL) caused hyperglycemia compared to no addition of dextrose to RL.

Settings and designs: This prospective randomized study was conducted in 100 infants undergoing facial cleft surgery at a tertiary care institution.

Subjects and methods: Group D received RL with 2% dextrose and Group R received RL without the addition of dextrose. Blood sugars were measured at induction, 1 h and 2 h later. Hyperglycemia was defined as blood sugar >150 mg/dL and hypoglycemia as <70 mg/dL.

Statistical analysis used: Pearson's Chi-square test, Paired t-test, Mann-Whitney test, and Independent sample t-test were used as applicable.

Results: Baseline blood sugar was comparable in both groups. A significant increase in blood sugar values from baseline was seen in both groups, but the increase was significantly more in Group D at 60 min (136.5 ± 41.9 vs. 109.2 ± 20.5) and at 120 min (150.1 ± 45.5 vs. 123.1 ± 31.7). The incidence of hyperglycemia was 50% in Group D and 12% in Group R. No patient developed hypoglycemia intraoperatively. No significant correlation between blood sugar and hours of fasting was established.

Conclusion: Routine addition of dextrose to RL is not essential during short surgeries under general anesthesia in infants, provided preinduction blood sugar level is >70 mg/dL and intraoperative sugars are periodically monitored.

Keywords: Dextrose; Ringer's lactate; hyperglycemia; hypoglycemia; infants.

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
CONSORT flow diagram
Figure 2
Figure 2
Changes in blood sugars
Figure 3
Figure 3
Comparison of hyper and euglycemia

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Source: PubMed

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