Fifty Non Insulin Dependent Diabetes Mellitus (NIDDM) patients undergoing surgery under epidural anaesthesia were studied. All patients received dextrose 5% infusion at 100 ml/hr from the period of fasting until upon arrival to the operation room. Patients were randomly divided into two groups. Patients in Group 1 (n=25) received normal saline while patients in Group 2 (n=25) were given Ringer’s lactate. Both groups received their infusion throughout the operative period up to four hours postoperatively. Blood glucose level was measured at baseline, 45 minutes intra operatively and postoperatively at 30 minutes and four hours by using a glucometer. Patients in Group 2 has a larger mean increase in blood glucose level of 1.5 mmol/L between 4 hours postoperatively and baseline compared to 0.96 mmol/L in Group 1. However, this was not statistically significant. There was no difference in the increase of mean glucose level at 30 minutes when compared to baseline. There was a significant increase in mean blood glucose level in both groups in the postoperative period when compared to baseline. This study demonstrated that patients with NIDDM receiving Ringer’s lactate has a larger increase in mean blood glucose level compared to those receiving normal saline, but the magnitude is not statistically significant.
Intraoperative Glycaemic Control in Non Insulin Dependent Diabetes Mellitus: A Comparison between Normal Saline and Ringer's Lactate
Author
Abstrak
Kajian ke atas 50 pesakit Non-Insulin Dependent Diabetes Mellitus (NIDDM) yang menjalani pembedahan di bawah anestesia (pelalian) epidural telah dijalankan. Kesemua pesakit diberi infusi dekstros 5% 100ml/jam dari masa berpuasa hingga pesakit tiba di bilik bedah. Pesakit dibahagikan kepada dua kumpulan secara rawak. Pesakit dalam Kumpulan 1 (n=25) menerima salin normal manakala pesakit Kumpulan 2 (n=25) diberi laktat Ringer. Kedua-dua kumpulan menerima infusi sepanjang masa pembedahan sehingga empat jam selepas pembedahan. Aras glukos darah diambil tiga kali, iaitu semasa permulaan (baseline), 45 minit semasa pembedahan sedang berjalan, 30 minit dan empat jam selepas pembedahan menggunakan glukometer. Hasil kajian menunjukkan paras glukos darah min 1.5 mmol/L lebih tinggi pada pesakit Kumpulan 2 di antara empat jam selepas pembedahan dan permulaan, (baseline) berbanding dengan 0.96 mmol/L di kalangan pesakit Kumpulan 1. Walau bagaimanapun, statistik menunjukkan keputusan ini adalah tidak signifikan. Tidak terdapat perbezaan paras glukos min pada 30 minit bila dibezakan dengan permulaan (baseline). Paras glukos darah min menunjukkan kenaikan yang signifikan pada kedua-dua kumpulan selepas pembedahan apabila dibezakan dengan paras glukos di waktu permulaan. Hasil kajian ini menunjukkan bahawa pesakit NIDDM yang menerima laktat Ringer mempunyai kenaikan paras glukos darah min yang lebih besar apabila dibezakan dengan pesakit yang menerima salin normal, akan tetapi, magnitudnya tidak signifikan dari segi statistik.
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Related Images
 table1.jpg "Table 1: Demographic data, duration of anaesthesia, volume of fluids infused and type of cases. Values expressed as mean ± standard deviation (SD) and number (n) where appropriate.")
 table2.jpg "Table 2: Mean blood glucose levels at different time of anaesthesia for two groups. Values expressed as mean ± SD, and number (n) where appropriate.")
