Effects of propofol, desflurane and isoflurane on perioperative blood glucose level in intracranial mass operation: A randomized controlled trial

doi:10.14717/jsurgarts-210107

Abstract

The aim of this study is to compare the effects of the propofol, desflurane and isoflurane on blood glu-cose levels in cranial surgery. Ninety, ASA I-II patients aged between 18-60 years old were scheduled for study. Induction was per-formed with fentanyl, propofol and cisatracurium in all patients. Anaesthesia was maintained using propofol 4-6 mg/kg/h in propofol group (Group P), desflurane and isoflurane 0.5-1 MAC in group desflurane (Group D) and group isoflurane (Group I). Remifentanil infusion was applied 0.5 µg/kg/min in all groups. Plasma glucose (PG) levels, systolic arterial pressure (SAP), diastolic arterial pressure, mean arterial pressure and heart rate measured. In the 1st, 2nd and 5th hour, PG levels were significantly lower in group P than group D. In the 2nd and 3rd hour, PG levels were significantly lower in group P than group I (p <0.05). In addition, SAP values in group D were found to be significantly lower than group P and group I. With this study, it was concluded that total intravenous anesthesia with propofol infusion in intracranial mass surgery is more effective than inhalation anesthesia such as desflurane and isoflurane in preventing the hyperglycemic response caused by surgical stress.

Highlights

Surgery or trauma often leads to neural, endocrinal, metabolic, and humoral responses depending on their magnitudes
When the mean age was compared between the groups, it was determined that the mean age of the group desflurane (Group D) was higher than that of Group P (p
When the groups were compared in terms of blood glucose levels over time, the values of Group P were significantly lower compared to group D at the 1st hour of operation (T4) (99.13 ± 16.14-117.07 ± 21.82 p = 0.02), at the 2nd hour of the operation (T5) (109.07 ± 21.39-125.22 ± 21.33 P = 0.034), at the 3rd hour (T6) (111.86 ± 19.14-137.39 ± 28.16 p = 0.004)

Summary

Introduction

Surgery or trauma often leads to neural, endocrinal, metabolic, and humoral responses depending on their magnitudes. Propofol has been revealed to reduce glucose metabolism by 15-55%, to keep blood glucose level unchanged during surgery and to maintain the balance between cerebral blood flow and cerebral oxygen consumption at infusion doses which cause burst suppression in the electroencephalogram (EEG) [4]. Such effects of hyperglycemia as immunosuppression, electrolyte imbalance, and increased carbon dioxide (CO2) production are prominent ones in terms of affecting postoperative mortality and morbidity. The effects of propofol, desflurane, and isoflurane on perioperative blood glucose levels were evaluated in patients scheculed to undergo an intracranial mass operation

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