El-Radaideh Khaled, Alhowary Ala A, Alsawalmeh Mohammad, Abokmael Ahmed, Odat Haitham, Sindiani Amer
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Jordan University of Science and Technology, P.O. Box 953, Irbid 21110, Jordan.
Department of Special Surgery, Faculty of Medicine, Jordan University of Science and Technology, P.O. Box 953, Irbid 21110, Jordan.
Anesthesiol Res Pract. 2019 Oct 1;2019:7585043. doi: 10.1155/2019/7585043. eCollection 2019.
This prospective study compared the blood glucose concentration with spinal anesthesia or general anesthesia in patients undergoing elective cesarean section surgery.
In total, 58 pregnant women who underwent elective cesarean section surgery were included in this prospective comparative study. Group S ( = 35) included patients who chose spinal anesthesia, and group G ( = 23) included patients who chose general anesthesia. The patients were allocated to the groups upon patients' preference. For the group G, the blood glucose concentration (BGC) was obtained 5 minutes before induction, T1, and 5 minutes after induction T2. For the group S, the BGC was obtained immediately before the injection of the local anesthetic agent T1 and 5 minutes after the complete block T2. For both groups, BGC was measured 5 minutes before the end of surgery T3 and 30 minutes after the end of surgery T4. For BGC measurements, we used a blood glucose monitoring system with a lancet device to prick the finger.
There was no statistically significant difference in the mean blood glucose concentration between the groups S and G in T1 (78.3 ± 18.2 vs. 74.3 ± 14.7, > 0.05) and T2 (79.2 ± 18.3 vs. 84.9 ± 23.7, > 0.05). The mean BGC was statistically significantly higher in group G in comparison to group S in the times 5 minutes before (80.2 ± 18.1 vs. 108.4 ± 16.7, < 0.05) and 30 minutes after the end of surgery (80.9 ± 17.7 vs. 121.1 ± 17.4, < 0.05).
There is a much lower increase in blood glucose concentration under spinal anesthesia than under general anesthesia. It is reasonable to suggest that the blood sugar concentration must be intraoperatively monitored in patients undergoing general anesthesia.
本前瞻性研究比较了择期剖宫产手术患者在脊髓麻醉或全身麻醉下的血糖浓度。
本前瞻性对照研究共纳入58例行择期剖宫产手术的孕妇。S组(n = 35)包括选择脊髓麻醉的患者,G组(n = 23)包括选择全身麻醉的患者。根据患者的偏好将患者分配至各组。对于G组,在诱导前5分钟(T1)、诱导后5分钟(T2)获取血糖浓度(BGC)。对于S组,在注射局部麻醉剂前即刻(T1)和完全阻滞5分钟后(T2)获取BGC。对于两组,均在手术结束前5分钟(T3)和手术结束后30分钟(T4)测量BGC。对于BGC测量,我们使用带采血针装置的血糖监测系统针刺手指。
S组和G组在T1(78.3±18.2 vs. 74.3±14.7,P>0.05)和T2(79.2±18.3 vs. 84.9±23.7,P>0.05)时的平均血糖浓度无统计学显著差异。在手术结束前5分钟(80.2±18.1 vs. 108.4±16.7,P<0.05)和手术结束后30分钟(80.9±17.7 vs. 121.1±17.4,P<0.05)时,G组的平均BGC显著高于S组。
脊髓麻醉下血糖浓度的升高远低于全身麻醉。建议对接受全身麻醉的患者术中监测血糖浓度。