Perioperative hyperglycemic response to single-dose dexamethasone in patients undergoing surgery under spinal anesthesia

Abstract

Abstract Background Dexamethasone is a potent corticosteroid when comes to effectively preventing postoperative nausea and vomiting (PONV). However, some studies have documented its association with hyperglycemia. In our study, we compared the effect of single-dose dexamethasone (8 mg) on blood glucose concentrations among diabetics and non-diabetic patients who received spinal anesthesia for elective lower abdominal and lower limb surgeries. Results We recruited 80 patients and divided them into two groups of 40 patients each. After dexamethasone administration, diabetic patients had an early peak rise of blood glucose levels at 3 h, (157.85 ± 12.19) compared to 6 h, (125.30 ± 14.95) in non-diabetics. In diabetic patients, blood glucose levels remained consistently over the baseline and maximum rise was seen at 12 h (188.25 ± 41.33), which obviated the need or administration of injection insulin. Hyperglycemia can lead to a variety of physiological derangements. Conclusions Although dexamethasone is a useful means of successful prevention and treatment of PONV, the clinician should use his clinical judgment before administering dexamethasone. Trial registration CTRI, CTRI/2020/06/025765, Registered 02 June 2020, prospectively registered, http://ctri.nic.in/Clinicaltrials/login.php .

Keywords

• Dexamethasone
• Diabetes mellitus
• Hyperglycemia
• Postoperative nausea
• Vomiting