Background: Intraoperative hyperglycemia is a common problem among patients undergoing orthopedic surgery. Its incidence varies from country to country and not clearly studied in developing countries. Method:Multi-center cross-sectional study was conducted on eligible adult elective patients who underwent orthopedic surgical procedures. The participants were selected using a systematic random sampling technique. Data was collected on basic characteristics, medical and surgical history. On the arrival of patients to the OR, blood glucose was measured and recorded and repeated after administering anesthesia. The data was analyzed using descriptive statistics and bivariate and multivariate logistic regression. P<0.05 was considered as statistically significant. Results: Intraoperative hyperglycemia was observed in 20.4% of patients. Hypothermia (AOR:2.45;95% CI:0.97-6.27, p=0.05), infused dextrose iv fluids (AOR:2.94;95% CI:1.64-5.16, p=0.05) , blood transfusion (AOR:6.64;95% CI:2.92-15.08, p=0.00) and history of hypertension (AOR:2.19;95% CI:1.23-3.71, p=0.01) were factors identified to be associated with intraoperative hyperglycemia. Conclusions and recommendations This study showed the magnitude of intraoperative hyperglycemia was high. Anesthetists should identify all risk factors preoperatively and make appropriate adjustments for patient care. Hypertension should be optimized, refrain from routine administering of dextrose IV fluids, and unnecessary transfusions, as well as monitor patients’ body temperature.

Background A significant proportion of patients suffer moderate to severe pain after surgery despite wide pain management protocols. Many analgesic drugs have been tried to alleviate perioperative pain. This study aimed at evaluating the effectiveness of diclofenac as a preemptive analgesic for postoperative pain management in patients that underwent abdominal hysterectomy under general anesthesia. Methods A total of 86 ASA I and II participants aged > 18 years old and undergoing abdominal hysterectomy from March to August 2020 in Adama General Hospital were recruited into this prospective observational cohort study. Study participants were grouped as group D (who took preemptive diclofenac) and group ND (who did not) based on whether or not IV diclofenac was given 30 minutes before the surgical incision. The pain severity, total analgesic consumption, first analgesic request time, and incidence of nausea and vomiting within 24 hours postoperatively were compared between the two groups. Student’s t-test and Mann-Whitney U test were used for analyzing numeric data. Categorical variables between the groups were analyzed using the chi-square test. P-values < 0.05 were considered statistically significant. Results Median pain score in the early postoperative period (in the 2nd, 4th, and 8th hr) was significantly lower in the diclofenac group (0.007, 0.004, 0.001, 0.261, and 0.796 respectively). The mean first analgesic request time between the groups was not significantly different (p > 0.05). Total postoperative analgesic consumption was significantly lower in the diclofenac group (p = 0.0006). The occurrence of nausea and vomiting was comparable between the two groups (p > 0.05). Conclusion and Recommendation: Preemptive diclofenac significantly reduced postoperative pain severity and total analgesic consumption and was associated with fewer side effects in patients undergoing gynecologic surgery. We recommend that all anesthesia providers use 75 mg of diclofenac 30 min to 1 hour before surgical incision.