Abstract
Background: Surgery causes a considerable metabolic stress in the non-diabetic and more so in a diabetic subject. In non-diabetic subjects the stress response is more in obese population than in non-obese due to the presence of insulin resistance. The severity of surgery as well as the type of anesthesia influences the magnitude of the counter regulatory response The study was undertaken to observe the effect of stress of surgery in obese and non-obese non-diabetic patients undergoing craniotomy under general anesthesia. Methods: A Prospective randomized parallel group study was done on a total of 100 patients. They were divided into two groups non-obese patients and obese patients comprising of 50 patients in each group depending on their BMI. If at any time intraoperative CBG was found to be more than or equal to 150mg/dL calculated dose of human soluble insulin was given as intravenous bolus equal to the amount of CBG/100 units. Results: 36% patients in obese population developed at least one episode of hyperglycemia (CBG ≥150 mg/dL) but only 20% in non-obese population did so. Insulin consumption was significantly higher in obese population than in non-obese population to maintain normoglycemia. The relative risk of becoming hyperglycemic in obese compared to non-obese is 1.80 (95% CI 0.92 to 3.51) Conclusion: We conclude that stress induced hyperglycemic response in patients undergoing craniotomy surgery under general anaesthesia is common in non-diabetic obese non-obese population.
Published Version
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