Key result
Anaesthesia and surgery significantly increased blood glucose levels from induction to the end of the procedure by a mean of 28.6 mg/dL in pediatric patients.
Why the study?
Does anaesthesia and surgery affect perioperative glucose levels in children?
Cross-Sectional (n=100)
No
Does anaesthesia and surgery affect perioperative glucose levels in children?
Mean Difference: 28.6 (95% CI 20.7–36.5)
Absolute Event Rate: 127.62% vs 99.04%
p-value: p=<0.001
Glycaemia significantly increases during anaesthesia and surgery in children, suggesting a need to optimize fasting times and IV fluid dextrose content.
May warrant closer perioperative glucose monitoring in children; leaves open optimal fasting and fluid strategies pending prospective trials.
BACKGROUND: Hypoglycaemia and hyperglycaemia may develop during anaesthesia and surgery in children and can lead to severe adverse clinical outcomes. No study, as far as we know, has investigated glucose homeostasis in children undergoing surgery in Malawi. The aim of this study was to assess perioperative glucose levels of the children undergoing anaesthesia at Mercy James Centre (MJC) for Paediatric Surgery, Blantyre, Malawi. METHODOLOGY: This was an observational cross-sectional study. We looked at 100 children aged 1 day to 15 years anaesthetised at MJC. Data were analysed using SPSS 28. Student t test and Analysis of the variance (ANOVA) were used to compare means. The level of significance was 5%. RESULTS: Male children represented 68%. The median age was 2.2 years. Sixten percents of patient were underweight. Fasting times were prolonged for 87%. Maintenance IV fluid with 2.5% dextrose was given to 14%. Overall, there was a significant increase of glycaemia from induction of anaesthesia to the end of the procedure. Hypoglycaemia was rare. The mean fasting glycaemia was 99.04 mg/dL ± 1.8, 116.95 mg/dL ± 34.2 at 30 min into the procedure and 127.62 mg/dL ± 46.8 at the end of the procedure. The differences in means were statistically significant (p < 0.001). Prolonged fasting times was associated with lower blood glucose means whereas nutrition status, type of the procedure, addition of dextrose in the fluid, and duration of procedure were associated with higher glycaemia means. CONCLUSION: Glycaemia increases under anaesthesia and surgery. Recommended fasting times, optimising nutritional status, when possible, no dextrose or lower than 2.5% dextrose in IV maintenance fluid are possible strategies to maintain blood sugar homeostasis during paediatric surgery and anaesthesia.
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Pascal et al. (2023) conducted a cross-sectional in Children undergoing anaesthesia and surgery (n=100). Anaesthesia and surgery vs. Baseline (induction) was evaluated on Change in blood glucose from induction to end of procedure (MD 28.6 mg/dL, 95% CI 20.7-36.5, p=<0.001). Anaesthesia and surgery significantly increased blood glucose levels from induction to the end of the procedure by a mean of 28.6 mg/dL in pediatric patients.
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