Comparison of Blood Glucose Levels, Blood Pressure, Heart Rate and Oxygen Saturation among Diabetic Patients undergoing General Anesthesia and Local Anesthesia with Sedation: A Cross-Sectional Study

Abstract

Background: Due to the rapidly increasing prevalence of diabetes mellitus (DM), the number of patients undergoing surgery and therefore requiring anesthesia has become higher than ever. In this study we aimed to compare blood glucose levels and hemodynamic parameters of patients with and without overt DM who have received general anesthesia and local anesthesia with sedation for cataract surgery.
 Methods: In this cross-sectional study, 120 patients with DM and 120 patients without DM were included. Each of these patients was randomly assigned to receive general anesthesia or local anesthesia with sedation. blood glucose levels and hemodynamic parameters were measured before surgery, 30 minutes after surgery and six hours after surgery.
 Results: There was no significant difference between the four groups in terms of age, gender and duration of surgery (P > 0.05). Blood glucose levels didn’t differ between non-diabetic patients receiving general and local anesthesia before or at any time after surgery (P > 0.05). Blood glucose levels were higher in diabetic patients compared to non-diabetics before or at any time after surgery (P < 0.001). 30 minutes and six hours after surgery, blood glucose levels of diabetic patients receiving general anesthesia were significantly higher than diabetic patients receiving local anesthesia with sedation (P < 0.001). No significant difference was noted regarding blood glucose changes during the study time frames in any of the 4 study groups. Diabetic patients receiving general anesthesia had higher blood glucose levels compared to non-diabetics and diabetic patients receiving local anesthesia with sedation (p < 0.001). Before surgery, the four study groups did not differ significantly in SBP, DBP, HR, RR and O2 sat (P > 0.05DBP, HR and RR were not different among the study groups 30 minutes after surgery (P > 0.05). SBP, DBP, HR and RR were not different among the study groups six hours after surgery (P > 0.05).
 Conclusion: Patients receiving general anesthesia should be monitored more closely to prevent anesthesia-induced respiratory depression. Using local anesthesia with sedation instead of general anesthesia can help prevent the detrimental effects of perioperative hyperglycemia in diabetic patients undergoing cataract surgery.