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Category: Volume 06 Issue 01 January 2018
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Title: Clinical evaluation of effects of Intravenous Induction agents: propofol, ketamine and etomidate on blood sugar level

Authors: Alok Kumar Sahoo, Indraprava Mandal, Kalpana M

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i1.151

Abstract

Background: Hyperglycaemia is one of the stress responses to surgery and anaesthesia. Studies reported that volatile anaesthetics mainly sevoflurane impaired glucose use, suggesting a possible contribution to intraoperative hyperglycaemia.

Aim:  To establish an effect if any on blood sugar by IV induction agents.

Methods: It is a prospective observational study. We selected 90 patients of either sex, ages between 18-55 yrs, ASA grade I /II undergoing elective minor surgical procedures with expected duration of 10-15 mins. All patients were divided into three groups (n =30 each);Group –A : received propofol 2 mg/kg, Group-B : received ketamine 2 mg/kg, Group – C : received etomidate 0.3 mg/kg. Blood sugar levels were  measured before giving induction agents ( at 0 min , taken as baseline ) then at 5 mins,15 mins, 30 mins, 60 mins,90 mins and 120 mins interval. Hemodynamic parameters like heart rate (HR), mean arterial pressure (MAP) were also measured at similar time interval as blood glucose level. The values of each time interval was compared with respect to baseline value within a group by independent sample t-test.

Results: There were no significant differences between groups with respect to age, weight, gender distribution and duration of surgery. There was no significant change in blood glucose level in propofol. Ketamine increased blood sugar level which was statistically significant (p < 0.05) after 30 mins and 60 minutes from its administration but did not produce clinically significant hyperglycemia (> 180 mg/dl) at any of the study interval. Etomidate decreased blood glucose level which was significant ( p < 0.05 )  after 2 hrs but was within  the  physiological range. Blood sugar level never decreased to < 60mg/dl. Propofol showed significant decrease in HR and MAP after 5 mins of giving induction agent. Ketamine showed significant increase (p < 0.05) in HR at 5 mins and 15 mins after giving induction agent. Etomidate showed no significant changes in HR & MAP. 

Conclusion: Intravenous induction agents also result in impaired glucose response, though the changes are within physiological limits. Hyperglycemia occured with ketamine.

Keywords: Blood sugar level, etomidate, hyperglycemia, induction agent, ketamine, propofol.

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Corresponding Author

Indraprava Mandal

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