Effect of dexmedetomidine premedication on the intraoculor pressure and metabolic control in type 2 diabetic patients undergoing cataract operation

This study was designed to evaluate the effect of dexmedetomidine [DEX] on the blood glucose control and insulin requirements in type 2 diabetic patients. Besides its effect on the intraocular pressure [IOP] in same patients, during cataract operations. Twenty patients with type 2 diabetes of ASA physical state II were randomly allocated into two equal groups. DEX group received 0.6 ug/Kg I.V. dexmedetomidine premedication and control [saline] group. Received i.v. 0.9% saline. Patients received standard general anesthesia. Insulin was given by continuous i.v. infusion syring pump 1.25 U/h. and intermittent bolus doses to maintain blood glucose range 5.5-11.1 mmol/ L. Blood glucose levels were measured every 15 minutes intra operatively. Cortisol, growth hormone and C-peptide were also measured IOP was measured with schioltz tonometer The results of this study demonestrated that the total insulin requirement and the blood sugar concentrations were significantly lower in DEX group than control group throughout the study period. There were no significant differences between the two groups in the cortisol levels. Though growth hormone levels were significantly increased in DEX. group but still within the normal physiological limits. C-peptide levels were significantly, lower in DEX group than in control group. In addition DEX significantly reduced the IOP in DEX group than in control group. From these data we can conclude that i.v. dexmedetomidine premedication improves blood glucose control and decreases insulin requirements and intraoculor pressure so it improves the operating conditions for type 2 diabetic patients undergoing cataract operation