Comparative study of 6% Hydroxyethylstarch–450 & Dextran–40 on blood sugar levels during surgery under spinal anaesthesia

Dr. Prof (Col) V. R. R CHARI; Dr ARNAB PAUL

Volume : V, Issue : VI, June - 2015

Comparative study of 6% Hydroxyethylstarch–450 & Dextran–40 on blood sugar levels during surgery under spinal anaesthesia

Dr. Prof Col V. R. R Chari, Dr Arnab Paul

Abstract :

Background and objectives: Fluid resuscitation with colloids and crystalloids as preloading fluids is done prophylactically to limit complications following spinal anaesthesia. Aim of this study was to examine and compare the effects of 6% hydroxyethyl Starch–450 and Dextran–40 on blood sugar level during surgery under spinal anaesthesia and their potential to induce or potentiate hyperglycaemia. Material and method: After obtaining permission from Institutional Ethics Committee (IEC), study was conducted in 90 non–diabetic patients of ASA–I, age 18–65 yrs posted for elective surgery under spinal anaesthesia in our institute. They were randomly divided into 3 groups (A,B,C) by computer generated random number table. Following fluids were administered iv over half an hour prior to the subarachnoid block: Group A– Ringer’s Lactate, 20 ml/kg, Group B– Dextran – 40, 10 ml/kg Group C– Hestar 6 % – 450, 10 ml/kg. Serial capillary blood glucose measurements were taken at regular intervals at 15, 30, 45, 60, 120, 180 and 240 minutes using a glucometer. Statistical analysis was done by ANOVA (one way) with Bonferroni’s post hoc test to compare the two groups with referance to the control group. Result: Ringer’s lactate and Hestar 6% – 450 increased the capillary blood glucose levels which was statistically significant (p < 0.05) but the rise with Dextran – 40 was sustained and statistically highly significant (p < 0.001). With Ringer's Lactate, maximal mean blood glucose levels of 95.16 ± 16.421 mg/dl were found at 45 minutes. With Hestar 6% – 450, maximal blood glucose levels of 105.26 ± 16.197 mg/ dl were found at the end of 1 hour. With Dextran – 40, maximal blood glucose level of 215.43 ± 45.159 mg/dl were found at 45 minutes. Conclusion: Under stressful conditions, Ringer’s lactate and Hestar 6%–450 significantly raise the blood sugar level within physiological limits whereas Dextran–40 raises the blood sugar to a level well above the physiological limit, causing a sustained and significant rise in peri–operative blood sugar levels.