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在接受白内障手术的糖尿病患者中,使用丙泊酚 - 芬太尼和咪达唑仑 - 芬太尼进行轻度镇静期间及之后的血糖水平变化。

Changes in blood glucose level during and after light sedations using propofol-fentanyl and midazolam-fentanyl in diabetic patients who underwent cataract surgery.

作者信息

Khalighinejad Pooyan, Rahimi Mojtaba, Naghibi Khosro, Niknam Negar

机构信息

School of Medicine, Feiz Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

Department of Anesthesiology, Feiz Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Adv Biomed Res. 2015 Oct 7;4:222. doi: 10.4103/2277-9175.166645. eCollection 2015.

Abstract

BACKGROUND

Surgeries may trigger the stress response which leads to changes in blood glucose level, and studies suggest that different sedation and anesthesia methods have different effects on blood glucose level. The aim of this study was to investigate changes of blood glucose levels in diabetic patients and compare them in two sedation methods of propofol + fentanyl and midazolam + fentanyl.

MATERIALS AND METHODS

Totally, 80 diabetic candidates for cataract surgery who had all the inclusion criteria, underwent cataract surgery using two methods of propofol (1 mg/kg/h) + fentanyl (2 μg/kg) (Group P) and midazolam (0.03 mg/kg) + fentanyl (2 μg/kg) (Group M) for light sedation. In the end, 70 patients (Group P n = 35 and Group M n = 35) remained in the study. Patients' blood glucose levels, vital signs, and hemodynamic data were assessed 30 min prior to the surgery, each 15 min during surgery and at the end of surgery.

RESULTS

Hemodynamic parameters did not have a statistically significant difference between the two groups mean blood glucose level in Group M was 149.15 mg/dl and in Group P was 149.2 mg/dl, and based on repeated measures analysis of variance test, significant differences were not observed between the two groups (P = 0.99). T-test showed no significant differences in the blood glucose level at any time of the study between the two groups.

CONCLUSIONS

Light sedation methods of propofol + fentanyl and midazolam + fentanyl did not have any differences in alteration of blood glucose level.

摘要

背景

手术可能引发应激反应,导致血糖水平变化,且研究表明不同的镇静和麻醉方法对血糖水平有不同影响。本研究旨在调查糖尿病患者血糖水平的变化,并比较丙泊酚+芬太尼和咪达唑仑+芬太尼两种镇静方法下的血糖变化。

材料与方法

总共80名符合所有纳入标准的糖尿病白内障手术候选者,采用丙泊酚(1mg/kg/h)+芬太尼(2μg/kg)(P组)和咪达唑仑(0.03mg/kg)+芬太尼(2μg/kg)(M组)两种方法进行浅镇静下的白内障手术。最终,70名患者(P组n = 35,M组n = 35)留在研究中。在手术前30分钟、手术期间每15分钟以及手术结束时评估患者的血糖水平、生命体征和血流动力学数据。

结果

两组间血流动力学参数无统计学显著差异,M组平均血糖水平为149.15mg/dl,P组为149.2mg/dl,基于重复测量方差分析检验,两组间未观察到显著差异(P = 0.99)。t检验显示两组在研究的任何时间点血糖水平均无显著差异。

结论

丙泊酚+芬太尼和咪达唑仑+芬太尼的浅镇静方法在血糖水平改变方面没有差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ab4/4638056/116785579722/ABR-4-222-g001.jpg

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