Effect of Intraoperative Fluid on Blood Glucose Level in Neurosurgery
WICHAI ITTICHAIKULTHOL, M.D.*, SOMSRI PAUSA WASDI, M.D.*, V ARINEE LEKPRASERT, M.D.*, PRATHOMPORN SUCHARTWATNACHAI, M.D.*
Affiliation : * Department of Anesthesiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
Abstract
There is a considerable controversy regarding glucose administration during intracranial
surgery. However, recent animal and human studies suggest that hyperglycemia exacerbates
ischemic brain damage and intraoperative hypoglycemia may not be a concern if the surgical
procedure is less than 4 hours.
We, therefore, studied the blood glucose in neurosurgery with craniotomy in 90 Thai
patients, divided into 3 groups. 30 patients in each group received balanced salt solution (0.9%
NSS), 5 per cent glucose rate 60-80 ml/h and 5 per cent glucose rate more than 120 ml!h.
Blood for the determination of glucose concentration was obtained after induction and every 2
hours later until the end of the surgery.
There was one male patient in group I who received balanced salt solution (0.9% NSS) had
blood glucose concentration lowered to 57 mg% at 4 hours after induction. The patients in group
II who received 5 per cent glucose solution at maintenance rate did not have hyperglycemia
(161.20±38.30 mg%). In group III ; patients given 5 per cent glucose infusion at the rate of more
than 120 ml/h had hyperglycemia (236.75±63.57 mg%) at 6 hours. In conclusion, we suggest
that in Thai patients undergoing neurosurgical procedures; blood glucose levels should be checked
intraoperatively if glucose is withheld from the intraoperative fluid regimen. Otherwise 80 ml/h
of 5 per cent dextrose intravenous infusion should be given to the patients to prevent hypogly-
cemia.
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