title: Influence of two anesthetic techniques on blood sugar level in head injury patients: A comparative study.
abstract: BACKGROUND
  Head injury presents a major worldwide social, economic, and health problem. Hyperglycemia is a significant indicator of the severity of injury and predictor of outcome, which can easily be prevented. There has been a long-standing controversy regarding the use of inhalational or intravenous (i.v.) anesthetic agents for surgery of head injury cases and impact of these agents on blood sugar level.
  
  
  OBJECTIVE
  The aim of this study is to find out anesthetic drugs and technique having minimal or no effect on the blood sugar, and Glasgow Coma Scale (GCS) of patients with a head injury by comparing two types of anesthetic techniques in surgery of head injury patients.
  
  
  METHODS
  This was a prospective, randomized, and comparative study, conducted on 60 adult head injury patients. The patients were divided into two groups of 30 each. Group I patients received induction with sevoflurane and then had O2 + air + sevoflurane for maintenance with controlled ventilation. Group II patients received induction with i.v. propofol and then had O2 + air + propofol for maintenance with controlled ventilation. Injection fentanyl was used in both the groups at the time of induction and in intermittent boluses in maintenance. In observation, blood sugar level and mean arterial pressure were assessed at different time periods perioperatively in both groups while GCS was analyzed pre- and post-operatively.
  
  
  METHODS
  Statistical analysis was performed by Microsoft Excel 2010 using t-test for comparison between the two groups and Z-test for comparison of proportions.
  
  
  CONCLUSIONS
  Blood sugar level was found significantly higher in patients of sevoflurane group at 30 min after induction, at the end of surgery, and 1 h after the end of anesthesia than propofol group patients. This increase of blood sugar level did not have any significant alteration in the GCS profile of the patients in sevoflurane group as compared to propofol group patients. Nausea and vomiting were found more in sevoflurane group while hypotension and bradycardia were found more with propofol group.
authors.affiliation: Department of Anesthesia, Madan Mohan Malviya Hospital, New Delhi, India.
authors.forename: Manoj
authors.initials: M
authors.lastname: Kumar
authors.affiliation: Department of Anesthesia and Critical Care, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Manoj
authors.initials: M
authors.lastname: Tripathi
authors.affiliation: Department of Anesthesia and Critical Care, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Malviya
authors.affiliation: Department of Anesthesia and Critical Care, MLN Medical College, Allahabad, Uttar Pradesh, India.
authors.forename: P S
authors.initials: PS
authors.lastname: Malviya
authors.affiliation: Department of Anesthesia and Critical Care, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Virendra
authors.initials: V
authors.lastname: Kumar
authors.affiliation: Department of Anesthesia and Critical Care, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Tyagi
keywords: Head injury; hyperglycemia; propofol; sevoflurane