Effect of perioperative fluid therapy on blood glucose in neonates undergoing gastrointestinal operation / 中华麻醉学杂志

ABSTRACT

Objective To investigate the effect of perioperative fluid therapy on blood glucose in the neonates undergoing gastrointestinal operation. Methods Sixty-four ASA Ⅰ or Ⅱ neonates undergoing gastrointestinal operation were randomly divided into 4 groups ( n = 16 each). Group Ⅰ received water orally 2 h before operation and iv infusion of acetated Ringer's solution during operation. Group Ⅱ received water orally 2 h before operation and iv infusion of 2% glucose (in normal saline) during operation. Group Ⅲ received 10% glucose 5 ml/kg orally 2 h before operation and iv infusion of acetated Ringer's solution during operation. Group Ⅳ received 10% glucose 5 ml/kg orally 2 h before operation and iv infusion of 2 % glucose (in normal saline) during operation. Blood sam ples were collected from radial artery for determination of blood glucose concentrations at the beginning of fluid therapy (T0), immediately after induction of anesthesia (T1), at the beginning of operation (T2), and at 20,40and 60 min (T3-5) and 2 h after operation ( T6 ). MAP and HR were also recorded simultaneously. The blood lactic acid concentration was determined at T0 . Results There was no significant difference in MAP and HR among the 4 groups. Compared with group Ⅰ , blood glucose concentrations were significantly increased at T4-6 in group Ⅱand Ⅳ, but no significant change was found in blood glucose concentrations at each time point in group Ⅲ. There was no significant difference in blood glucose concentrations between group Ⅱ and Ⅳ. The blood lactic acid concentration was significantly higher in group Ⅲ than in group Ⅰ , and in group Ⅳ than in group Ⅱ . Conclusion Oral 10% glucose 5 ml/kg before operation and iv infusion of 2% glucose (in normal saline) during operation is beneficial for the stabilization of blood glucose levels in neonates undergoing gastrointestinal operation.