ASSESSMENT OF INSULIN SENSITIVITY IN OBESE, NONDIABETIC SUBJECTS UNDERGOING INFRAUMBILICAL SURGERY AND ITS VARIATION WITH GENERAL AND REGIONAL ANAESTHESIA - A PROSPECTIVE RANDOMIZED STUDY.

PROF (DR) SAMPA DUTTA GUPTA

Volume : VII, Issue : VI, June - 2018

ASSESSMENT OF INSULIN SENSITIVITY IN OBESE, NONDIABETIC SUBJECTS UNDERGOING INFRAUMBILICAL SURGERY AND ITS VARIATION WITH GENERAL AND REGIONAL ANAESTHESIA - A PROSPECTIVE RANDOMIZED STUDY.

Prof Dr Sampa Dutta Gupta

Abstract :

The greatest degree of insulin resistance occur on the second post–operative day after major surgery and persist upto three weeks.

Aim: To compare changes in insulin sensitivity ofnondiabetic obese patients undergoing general and regional anaesthesia.

Methods:

100 non diabetic obese posted for infra–umbilical abdominal surgeries under general and epidural anaesthesia.Serum insulin,glucose, cortisol,TNFα,IL6 and HOMA estimated before operation ,immediately after operation and 48 hrs after operation..

Result: There is significant increase of mean HOMA withinGroup G from preoperative to 48 hrs postoperative period,no changes seen within Group R at three point of time. Borderline difference (p–0.059) in immediate postoperative period ,and significant difference( p 0.000) at 48 hrs postoperative period seen between two groups. Changes in IL6, TNF–αbetween two groups at three different point of times shows no significant changes , but mean increase of IL6 and TNFα from preoperative to immediately and 48hrs postoperative period. Significant changes revealed in cortisol level between two groups from preoperative period to immediately and 48hrs postoperative periodwithin and between the groups..

Conclusion:Suitable anaesthetic and analgesic prevent deterioration of insulin sensitivity status in obese non diabetic patients undergoing surgery under anaesthesia.