The effect of dexamethasone on postoperative blood glucose levels in diabetic and nondiabetic Patients who are undergoing laparoscopic cholecystectomy

Document Type : Original research articles

Authors

Department ofAnesthesiology and Intensive Care and pain management, Faculty of Medicine, South Valley University, Qena, Egypt

Abstract

Background: Dexamethasone is a potent corticosteroid when administered alone or in
combination.Alone has proven efficacious in preventing nausea and vomiting (PONV)
perioperative.
However, the administration of even a single dose has been associated with hyperglycemia.
Objectives: This is a study that evaluates the effect of 8 mg dexamethasone on blood glucose
concentrations among diabetics and non-diabetics in patients who are undergoing
laparoscopic cholecystectomy.
Patients and Methods: After obtaining ethical clearance 60 American Society of
Anesthesiologists I and II patients undergoing laparoscopic cholecystectomy aged 18 to 65
years of either gender with body mass index <30 kg/m2 scheduled for elective laparoscopic
cholecystectomy under general anesthesia will be included in the study .patients will be
divided into two groups: Group A, 30 diabetic patients receiving 8 mg dexamethasone and
group B, 30 non-diabetic patients receiving 8 mg dexamethasone.
Blood glucose level will be estimated at 0, 6h, 12h, and 24h.
Results: The baseline blood glucose values were higher in diabetics compared to nondiabetics
(125.77±22.55 vs. 95.47±15.45 mg/dL). Throughout the study period, blood glucose
was significantly higher in diabetic than in non-diabetic patients. All patients in the study who
received dexamethasone had significantly higher blood glucose levels subsequently. The rise
of blood glucose from baseline was compared between the diabetic and non-diabetic groups at
T6 and T12.the rise of blood glucose was similar in both diabetics and non-diabetics at T6.
However, at T12, the non-diabetic patients had statistically significant rise in blood glucose
levels in comparison with diabetics.
Conclusion: The maximum rise in blood glucose was in the range of 40–45 mg/dl in the
patients. The clinician should use his clinical judgment before administering dexamethasone
for PONV prophylaxis/treatment.

Keywords

Main Subjects