Abstract
Perioperative glycemic control is especially important in the surgical patient because intra-operative hyperglycemia in non-diabetic patients is linked to adverse outcomes. When surgical stressed trigger, the body releases cortisol, catecholamines and glucagon which stimulate hepatic glycogenolysis and gluconeogenesis regardless of fluid composition. Ringer Lactate is a commonly used balanced crystalloid fluid used in the perioperative period that lacks dextrose, however, its impact on perioperative blood glucose levels in non-diabetic surgical patients undergoing general anesthesia has not been thoroughly examined. Heavy Industry Taxila (HIT) hospital was used for a prospective observational study that lasted for about four months. Patients of ASA physical status I-II aged between 18–60 years who were undergoing elective surgery under general anesthesia were included in the study by convenience sampling and a total of 110 were evaluated. Exclusion criteria included medications that affect blood glucose, impaired glucose tolerance, diabetes, and pre-operative fasting blood glucose >126 mg/dl. Blood glucose level was measured at three times including preoperatively, intraoperatively and postoperatively. Of the preoperatively measured patients 69.1% had glucose levels in the range of 80-90 mg/dl. At the time of surgery, 43.6% were in the 101-110 mg/dl range. Among those who had surgery, 50.9% had a level between 111 and 120 mg/dl and none went below 91 mg/dl. There was a statistically significant correlation between the glucose levels before and during the operation (p = 0.001), before and after the operation (p = 0.001), and during and after the operation (p = 0.008). Ringer Lactate is ineffective at preventing stress-induced hyperglycemia in non-diabetic patients, in general anesthesia. While dextrose-free maintenance fluids are utilized, peri-operative glucose monitoring continues to be clinically important