Effects of Intravenous Anesthesia on the Plasma Glucose Level During Cataract Surgery Among Patients With Type II Diabetes

Abstract

Background: High blood sugar is a typical reaction to stress. In the diabetic population, hyperglycemia can be a serious issue and has been linked to higher mortality rates. Recent studies have shown that anesthetics reduced glucose tolerance; however, it is still unclear how propofol, ketamine, and thiopental of Na affect glucose metabolism. The present study compared the blood glucose levels of thiopental of Na, ketamine, and propofol among patients with cataract surgery. Materials and Methods: The study included 135 ASA II and III adult patients of both genders who were older than 65, known to have type II diabetes, receiving intravenous (IV) sedation, and scheduled for cataract surgery. The three groups were comparable with regard to patients, age, gender, weight, duration of the operation time, duration of recovery time, duration of diabetes, and anesthesiologist’s physical status (based on the American Society of Anesthesiology). Patients were randomly assigned to one of three groups, including receiving IV thiopental of Na 5 mg/kg/h (group T), ketamine 2 mg/kg/h (group K), or propofol 2 mg/kg/h (group P) after the induction of IV sedation with 1-2 mic/kg fentanyl and 0.03 mg/kg midazolam. Changes in blood glucose levels were examined as dependent variables in patients with cataract surgeries while under the influence of these medications up to 6 hours after. Results: The results showed that blood glucose concentrations increased significantly over time in all groups. Moreover, blood glucose concentrations did not differ significantly between the groups receiving the thiopental of Na ketamine or propofol at any measurement time. During the first post-administrative hour, the thiopental of Na, ketamine, and propofol groups demonstrated blood glucose levels of 114.2±16.24 mg/dL, 136.2±12.28 mg/dL, and 122.2±13.84 mg/dL, which were not statistically significant (P=0.72). Regarding the frequency and severity of blood glucose level changes during or after surgery, the groups did not significantly differ at any point in time. Conclusion: The findings of the present study suggest that the thiopental of Na, ketamine, and propofol have equal effects on glucose metabolism.

Keywords

• intraoperative
• postoperative hyperglycemia
• thiopental sodium
• ketamine
• propofol