Abstract
Context: Surgical trauma gives rise to a stress response in the human body resulting in hyperglycaemia in the perioperative period. This adversely affects the patient’s outcome. Hyperglycaemia is particularly detrimental in patients with diabetes mellitus. Dexmedetomidine, an alpha 2 adrenoreceptor agonist attenuates this surgical stress response and helps in preventing perioperative hyperglycaemia.
Aims: The aim of our study was to monitor and compare the effect of dexmedetomidine versus normal saline on blood glucose levels intraoperatively and postoperatively in patients with diabetes mellitus undergoing spinal anaesthesia surgeries. Other objectives were, to compare haemodynamic changes, ramsay sedation scores intraoperatively andthe requirement of analgesia in the postoperative period between both the groups.
Methods: A double blind prospective randomized controlled study was conducted in a tertiary hospital. Out of 60 patients with diabetes mellitus, 30 random patients were administered with intravenous dexmedetomidine after giving spinal anaesthesia. The other half of patients received a placebo. Vital parameters and blood glucose levels were monitored and compared in both the groups. Statistical analysis used: Data was tabulated and compared using unpaired T-test.
Results: Statistically significant differences were found in mean heart rate and blood pressure between both the groups. The differences in the blood sugar values in the intra operative period and the postoperative period between both the study groups were also statistically significant. Requirement of additional postoperative analgesics were also considerably less in the dexmedetomidine group.
Conclusion: Intravenous dexmedetomidine attenuates the surgical stress response by inhibiting the adrenal surge and prevents hyperglycaemia.