Perioperative management of hyperglycemic patients undergoing surgery: an observational cross sectional study in a tertiary care hospital

Abstract

Background: Diabetes poses an additional risk during anesthesia, yet there is a lack of sufficient Indian data on perioperative antidiabetic drug use and its implications. This droves us to conduct the study.

Methods: Cross-sectional, observational study, conducted in a tertiary care hospital's general surgery and orthopaedics wards. Data collected from the first anaesthetist visit to 24 hours postoperative period included antidiabetic medications, anesthesia drugs, blood sugar levels, co-morbidities, concomitant medications, and intravenous (IV) fluids. Descriptive statistics and parametric tests were used for analysis.

Results: The study comprised 180 patients (62.8% males, median age 56 years), with diabetes duration predominantly between 1-5 years (28.3%). Preoperatively, metformin was the most prescribed oral hypoglycemic agent (72.2%), decreasing to 56.67% postoperatively. Intraoperatively, only 1.6% received insulin, while 98.4% received no drugs. Common postoperative antidiabetic agents included insulin BD (n=48). General surgery (73.3%) and orthopedics (26.7%) contributed 132 and 48 patients, respectively, with spinal anesthesia (68.3%) and bupivacaine (75.4%) being most prevalent. Blood glucose during surgery was effectively monitored. Hypertension (52.8%) was the most common co-morbidity, and Ringer lactate (60.8%) was the predominant IV fluid.

Conclusions: Adequate perioperative antidiabetic management was observed in hyperglycemic patients.