Blood glucose level in neurosurgery. Is it different between isoflurane and desflurane anesthesia?
OBJECTIVE
A tight control of blood glucose is critical. We compare blood glucose level between isoflurane and desflurane in neurosurgical patients for further application.


METHODS
One hundred and eight patients scheduled for neurosurgery under general anesthesia were recruited and divided into two groups; fentanyl-isoflurane-nitrous oxide based and fentanyl-desflurane-nitrous oxide based randomly. Vital signs, end tidal gas concentration, amount of narcotics usage and blood glucose level were recorded at induction (T0) and intraoperative hourly thereafter (T1-T8). Independent t-test and ANOVA were used. The statistical significance was considered if p-value < 0.05.


RESULTS
There were 107 patients enrolled excluded one from isoflurane group because of the schedule changes. The amounts of fentanyl usage (0.89+/-0.41 mcg/kg/hr, 0.88+/-0.48 mcg/kg/hr), the end tidal inhales' tension (0.71%+/-0.32, 3.13%+/-1.63) were equivalent in isoflurane and desflurane group. The blood glucose levels at various period of time had no statistical difference but there was a significant (p<0.05) increasing from T1 to T8 comparing to T0 in both groups (3.88+/-0.93 mg%/hr and 5.55+/-1.14 mg%/hr).


CONCLUSIONS
Desflurane has demonstrated the indistinguishable blood glucose level and hemodynamic response from isoflurane anesthesia intraoperatively in neurosurgical patients, confirming a comparable pattern of blood glucose concentration intensifying over time spends.
Akavipat
Phuping
P
Department of Anesthesiology, Prasat Neurological Institute, Bangkok 10400, Thailand. ppakvp@hotmail.com
Polsayom
Nutchanun
N
Pannak
Songwut
S
Punkla
Walaiporn
W
D000293:Adolescent; D000328:Adult; D000368:Aged; D000769:Anesthesia, Inhalation / Q000379:methods*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D001786:Blood Glucose / Q000032:analysis*; D000077335:Desflurane; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control; D007431:Intraoperative Complications / Q000517:prevention & control; D007530:Isoflurane / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D009422:Nervous System Diseases / Q000097:blood / Q000601:surgery; D018696:Neuroprotective Agents; D019635:Neurosurgical Procedures; D055815:Young Adult
D018685:Anesthetics, Inhalation; D001786:Blood Glucose; D018696:Neuroprotective Agents; D000077335:Desflurane; D007530:Isoflurane