Original Articles
Assessment of impact of intraoperative glycemic control as a biomarker for postoperative recovery characteristics among diabetic and non-diabetic patients undergoing laparoscopic cholecystectomy under general anesthesia | |
Dr. Seetha Katta, Dr. A Hareesh, Dr. Y Murali Mohan, Dr. Pentagoud | |
Background: Diabetes mellitus encompasses a collection of chronic metabolic disorders, all of which are marked by increased blood glucose concentrations due to the body's insufficient insulin production, insulin resistance, or a combination of both. Hence; the present study was conducted for assessing impact of intraoperative glycemic control as a biomarker for postoperative recovery characteristics among diabetic and non-diabetic patients undergoing laparoscopic cholecystectomy under general anesthesia. Materials & methods: 40 patients of either sex, of age above 30 and below 60 years and American Society of Anesthesiologists (ASA) Grade I-II undergoing laparoscopic cholecystectomy under general anesthesia were enrolled in present study. Pre anesthetic checkup was done a day prior to surgery. Demographic information, clinical comorbidities, and operative details were abstracted from the clinical records using standardized definitions. Patient diabetic status, history of medication in past and insulin use, smoking status, weight, height, history of coronary artery disease, history of hypertension, indication for surgery were noted. Complete general physical examination and systemic examination was done in pre anesthetic evaluation. Baseline glucose measurement was obtained in preoperative assessment at central laboratory. All the patients were divided the patients into 2 groups: Group A: Controlled diabetics (20 patients), and Group B: Non diabetics (20 patients).Intra-operative monitoring was done. Intraoperative glycemic profile was recorded. Postoperative follow-up was done in all the patients was assessed. Results: Mean age of the diabetic patients and non-diabetic patients was 43.9 years and 41.8 years respectively. Majority proportion of patients were males. Among diabetic group, mean RBS at Baseline, 5 mins intraoperative, 10 mins intraoperative, 20 mins intraoperative and 30 mins intraoperative was 130.8 mg/dL, 138.6 mg/dL, 159.9 mg/dL, 133.9 mg/dL and 135.4 mg/dL respectively. Among non-diabetic group, mean RBS at Baseline, 5 mins intraoperative, 10 mins intraoperative, 20 mins intraoperative and 30 mins intraoperative was 93.6 mg/dL, 92.9 mg/dL, 92.5 mg/dL, 93.6 mg/dL and 94.7 mg/dL respectively. Significant correlation was seen between postoperative recovery profile and intraoperative glycemic profile among diabetic group. Conclusion: Diabetes has the potential to impact various organ systems within the body, and if left unmanaged, it may result in significant complications over time. Intraoperative glycemic profile can be useful in predicting recovery profile in diabetic patients. |
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