Abstract

Dr. Sarmed Mohammed Noori*, Dr. Mohammed Kassim Al Rubaye, Dr. Zinah Tahseen Alkinani

ABSTRACT

Background: Surgery is known to induce stress and disrupt metabolic activities, potentially leading to stress hyperglycemia, making it crucial to investigate whether the choice of anesthesia modality plays a role in blood glucose regulation during the perioperative period. Aim of the study: This study aims to compare blood glucose levels in elective lower abdominal surgery patients receiving general versus spinal anesthesia. Patients and methods: A prospective single-blinded comparative study was conducted at Medical City and Baghdad Teaching Hospital from June 1st, 2022, to June 1st, 2023. Sixty patients were conveniently sampled and divided equally into two groups: Group A received general anesthesia, and Group B received spinal anesthesia. Baseline demographic data and intraoperative information, including surgical duration, were collected. Blood glucose level was monitored during the procedure, with the primary outcome measure being changes in blood glucose levels from baseline in the two study groups. Results: In the study, mean ages between the groups (35.8 vs. 40.7 years) showed no statistical significance (p = 0.064). Body weight and height were similar, but BMI differed significantly (p = 0.025). ASA classification and surgery duration did not significantly differ (p = 0.4 and p = 0.3, respectively). Before induction, blood glucose levels were not significantly different (p = 0.3), with the general group at a mean of 106.8 ± 10.1 mg/dL and the spinal group at a mean of 103.8 ± 12.1 mg/dL. At 10 minutes post-induction, no significant difference was found (p =0.3) with means of 109.5 ± 10.3 mg/dL and 106.2 ± 13.3 mg/dL for the general and spinal groups, respectively. However, a significant divergence was observed before end of the surgery (p = 0.039), with the general group at a mean of114.8 ± 8.2 mg/dL and the spinal group at a mean of 110.1 ± 9.0 mg/dL. This difference persisted at 20 minutes after surgery (p = 0.024), with means of 116.1 ± 9.1 mg/dL for the general group and 111.1 ± 7.8 mg/dL for the spinal group. Conclusion: General anesthesia was shown to increase the blood glucose level at the end of surgery more than spinal anesthesia.