[Effects of different concentrations of glucose infusion during the cleft lip and palate repair in infant patients].
OBJECTIVE
To analyze the feasibility of regular infusion with different concentrations of dextrose and blood glucose monitor in infant from 2 to 12 months during operation.


METHODS
Ninety ASA(American Society of Anesthesiologists) I-II infants (age 2-12 months) who undertook cleft lip and palate repair (excluding patients with congenital diabetes) were divided into three groups (30 cases per group). Group I patients were infused with normal saline, Group II with 2.5% (mass fraction) dextrose in normal saline and Group III with 5% (mass fraction) dextrose, all by a rate of 6-8 mL/ (kg x h). Once the patient was sent into the operation room, Electrocardiogram(ECG) and Pulse Oxygen Saturation[SpO(2)] monitor were applied regularly; and anesthesia was inducted and maintained with sevoflurane in oxygen. The infants' age, gender, weight, fasting time, operation time and duration of anesthesia were recorded and the blood glucose concentrations before infusion, 10 minutes and 30 minutes after induction as well as at the end of operation were recorded.


RESULTS
There were no differences in age, gender, weight, fasting time, operation time and duration of anesthesia among the three groups. The differences of blood glucose concentrations before induction had no statistical significance among the three groups. The blood glucose concentration after induction was higher than that before induction in each group. The occurrence of lower level of blood glucose in Group I was 13.3% (4/30, 2.8-4.3 mmol/L), with the lowest value being 3.1 mmol/L. None was detected hyperglycemia. In Group II, blood glucose value after induction was lower than Group III and higher than Group I at every time point and incidence rate of hyperglycemia was 10% (3/30, >11.1 mmol/L), with the highest value being 12.7 mmol/L. Blood glucose in Group III was higher than both Group I and Group II after infusion. Incidence rate of hyperglycemia in Group III was 70% (21/30, >11.1 mmol/L), with the highest value being 22.1 mmol/L. After induciton 5, 10 min and the end of operation, blood glucose values with group I were (5.8 + or - 1.3) mmol/L, (8.4 + or - 1.7) mmol/L and (10.6 + or - 2.8) mmol/L; group II were (6.3 + or - 1.4) mmol/L, (8.5 + or - 2.5) mmol/L and (11.3 + or - 2.9) mmol/L; group III were (6.6 + or - 1.5) mmol/L, (8.2 + or - 2.1) mmol/L and (12.2 + or - 3.5) mmol/L.


CONCLUSIONS
2.5% dextrose (at a rate of 6-8 mL/ (kg x h) is appropriate for infants during cleft lip and palate repair, while regular blood glucose monitor should be applied during operation.
Department of Anesthesiology, Peking University School and Hospital of Stomatology, Beijing 100081, China.
Ming
M
Guan
Rui-chang
RC
Liu
Xu-dong
XD
Yang
Wen
W
Dong
Ke-ying
KY
Liu
D001786:Blood Glucose / Q000032:analysis; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D005947:Glucose / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D007430:Intraoperative Care; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*
D001786:Blood Glucose; D005947:Glucose