The effect of gestational diabetes mellitus on sufentanil consumption after cesarean section: a prospective cohort study

Chen Yang,Shaoqiang Huang,Wei Lian Geng,Jianying Hu

doi:10.1186/s12871-019-0925-1

Chen Yang, Shaoqiang Huang + Show 2 more

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https://doi.org/10.1186/s12871-019-0925-1

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Abstract

BackgroundPrevious studies have shown that patients with long-term diabetes require more opioids after surgery than patients without diabetes. Gestational diabetes mellitus (GDM) normally only lasts for a brief period; nevertheless, its effect on sufentanil consumption after cesarean section is unknown.MethodsThis prospective cohort study included two groups: a GDM group (n = 32) and a matched non-GDM (NGDM) group (n = 32). All patients underwent routine combined spinal-epidural anesthesia for cesarean delivery. Sufentanil consumption through an intravenous patient-controlled analgesia (PCA) pump, the frequency of PCA requests, and visual analog scale (VAS) scores 6 and 24 h after surgery were compared between groups.ResultsSufentanil consumption (μg) 6 h after surgery was higher in the GDM group than in the NGDM group (24.0 ± 6.6 vs 20.1 ± 5.7, P = 0.023). PCA was used more frequently 6 and 24 h after surgery by the GDM group than by the NGDM group (1[0–2] vs 0[0–1], P = 0.001; 6 [1–5] vs 3 [1, 2, 6–8], P = 0.001, respectively). The VAS score during activity 24 h after surgery was higher in the GDM group than in the NGDM group (5 [2, 3] vs 5 [1, 2], respectively, P = 0.03).ConclusionPregnant women with GDM require more opioids during the immediate postoperative period after cesarean section than those without GDM.Clinical trials registrationNo. ChiCTR1800016014, ChenYang, May 6th 2018.

Highlights

Previous studies have shown that patients with long-term diabetes require more opioids after surgery than patients without diabetes
For each pregnant woman included in the Gestational diabetes mellitus (GDM) group, a pregnant woman without GDM who matched with respect to height ± 2 cm, weight ± 1 kg, and the same parity was included in the nonGDM (NGDM) group (Fig. 1)
Preoperative laboratory tests showed that fasting blood glucose was higher in the GDM group than in the NGDM group, despite blood glucose management in the GDM group

Summary

Introduction

Previous studies have shown that patients with long-term diabetes require more opioids after surgery than patients without diabetes. Gestational diabetes mellitus (GDM) normally only lasts for a brief period; its effect on sufentanil consumption after cesarean section is unknown. Gestational diabetes mellitus (GDM) is defined as high blood glucose caused by impaired glucose tolerance detected and diagnosed during pregnancy. GDM is characterized by elevated fasting blood glucose and impaired glucose tolerance during pregnancy. The reference values used in the oral glucose tolerance test for pregnant women are as follows: fasting, 5.6 mmol/L; 1-h postprandial, 10.3 mmol/L; 2-h postprandial, 8.6 mmol/L; 3-h postprandial, 6.7 mmol/L. GDM is diagnosed when two or more test values reach or exceed the reference values. GDM is one of the most common complications of pregnancy, with a prevalence of approximately 3 to 7% [6,7,8]

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