Effect of perioperative dexmedetomidine infusion on blood glucose levels in non-diabetic morbid obese patients undergoing laparoscopic bariatric surgery

Background

This study was designed to assess the clinical efficacy of dexmedetomidine premedication on neuroendocrine stress response by analysis of perioperative fluctuation of blood sugar level during laparoscopic bariatric surgery. Dexmedetomidine when used as an additive to general anesthesia blocks stress response to various noxious stimuli, maintains perioperative hemodynamic stability.

Settings and design

Sixty patients undergoing laparoscopic sleeve gastrectomy were divided randomly into two groups. The dexmedetomidine group (Group D), received dexmedetomidine infusion, while the control group (Group C) received normal saline 0.9% in the same amount and rate as placebo. In group D, dexmedetomidine was given intravenously (IV) as loading dose of 1?μg/kg over 10?min prior to induction. After induction, it was given as infusion at a dose of 0.5?μg/kg/h for maintenance.Perioperative blood sugar levels were analyzed preoperatively, at 30?min after beginning of surgery then hourly till surgery ends, and six h after surgery. Anesthetic and surgical procedures were standardized. All patients were also assessed for intraoperative hemodynamic changes at specific timings, intraoperative narcotic consumption and recovery profile.

Results

Perioperative administration of dexmedetomidine infusion had essentially weakened the stress response. In the C group there was significantly higher blood sugar values compared to group D one hour after start of surgery up to 6?h later. Also, regarding hemodynamics there was significant reduction in heart rate (HR) and mean arterial blood pressure (MAP) in D group.

Conclusions

During the laparoscopic sleeve gastrectomy, dexmedetomidine premedication has effectively regulated the neuroendocrine stress response of general anesthesia as analyzed by perioperative blood sugar variation. Also, it maintained the hemodynamic stability.