Shyvi Ravindra Shetty, Abdul Rahman Ahlam, R Aithal Rashmi, Bhat Sonal, D Akshatha
Department of Anaesthesiology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India.
Anesth Pain Med. 2025 Apr 30;15(2):e161467. doi: 10.5812/aapm-161467.
This is a prospective observational study. Dexamethasone is commonly associated with postoperative hyperglycemia. There is limited data on the glycemic effect of dexamethasone among the diabetic population.
In the current investigation, postoperative glucose levels were measured in both diabetic and non-diabetic individuals, and then a single dose of intraoperative dexamethasone was administered.
A total of 86 participants, with ASA I/II, were categorized into two groups: Diabetic and non-diabetic. Each group consisted of 43 individuals. The participants' ages ranged from 18 to 70 years. During the operation, a single dosage of dexamethasone, with a maximum of 8 milligrams, was provided intraoperatively. "Postoperative nausea and vomiting" (PONV), random blood glucose (RBG), and pain ratings were recorded before surgery, immediately after surgery, after 12 hours, and 24 hours following surgery. Preoperative blood glucose levels were also recorded. The "Chi-square test and the unpaired -test" were used for comparison and to analyze the data. A significance level of P < 0.05 was deemed significant.
There was a statistically significant variance in RBG levels between diabetics and non-diabetics (P = 0.001). At various time periods, there was no correlation between the severity of PONV and diabetes among the participants. At various time intervals, the length of the procedure and the pain levels were equivalent to one another. In each group, there was a significant rise in RBG up to 12 hours, followed by a decline after 24 hours to a level similar to preoperative values.
A single dose of intraoperative "dexamethasone" was associated with transient hyperglycemia postoperatively up to 12 hours, which was more pronounced among the diabetic population and without major adverse effects like PONV in either group.
这是一项前瞻性观察性研究。地塞米松通常与术后高血糖有关。关于地塞米松在糖尿病患者中的血糖影响的数据有限。
在本次调查中，测量糖尿病患者和非糖尿病患者的术后血糖水平，然后给予单剂量术中地塞米松。
总共86名美国麻醉医师协会（ASA）分级为I/II级的参与者被分为两组：糖尿病组和非糖尿病组。每组由43名个体组成。参与者年龄在18至70岁之间。手术期间，术中给予单剂量地塞米松，最大剂量为8毫克。记录手术前、手术后即刻、术后12小时和24小时的“术后恶心呕吐”（PONV）、随机血糖（RBG）和疼痛评分。还记录术前血糖水平。使用“卡方检验和非配对检验”进行比较和数据分析。P < 0.05的显著性水平被视为具有统计学意义。
糖尿病患者和非糖尿病患者的RBG水平存在统计学显著差异（P = 0.001）。在各个时间段，参与者中PONV的严重程度与糖尿病之间无相关性。在各个时间间隔，手术时间长度和疼痛水平彼此相当。每组中，RBG在12小时内显著升高，随后在24小时后下降至与术前值相似的水平。
单剂量术中“地塞米松”与术后长达12小时的短暂高血糖有关，这在糖尿病患者中更为明显，且两组均未出现如PONV等主要不良反应。
