randomized clinical trial for the effects of halothane and isoflurane anesthesia on blood glucose levels in the diabetic patients

ABSTRACT

Halothane and isoflurane inhibit glucose-induced insulin secretion in animal and in vitro experiments.A randomized trial was designed to determine their in vivo effects in diabetic patients. Sixty diabetic patients with various malignancies were randomized to receive anesthesia with either halothane or isoflurane. Blood glucose level [BGL] was measured before induction and every 30 minutes during surgery and then after operation in the recovery room. Patients in both arms matched with gender, age, operation time, and initial BGL. In both arms an increase in blood glucose level could be detected 30 minutes after induction of anesthesia, but higher in the halothane arm. This difference was maintained for the next 30 minutes as well as the rest of duration of the anesthesia. Both arms had higher blood glucose levels after operation compared to initial, pre-anesthesia state, and this increase was more conspicuous in the halothane arm. No Halothane toxicity was detected during hospitalization. Although the effects of stress hormones was not evaluated, halothane anesthesia caused a greater degree of hyperglycemia compared to isoflurane anesthesia. This might be secondary to halothane's greater inhibitory effect