R. Raghu 1 , P. Indira 2 , R. Pandu Naik 3
ABSTRACT: BACKGROUND: Crystalloids and Colloids are extensively used as maintenance fluids in the perioperative period to maintain normal Homeostatic mechanisms. Ringer’s Lactate and Hydroxy Ethyl Starches produce significant levels of free glucose residues. AIM: To compare blood glucose levels by preloading with Ringers lactate solution at 20 ml/kg body weight versus 6% Hydroxy Ethyl starch @10ml/ kg body in non diabetic patients posted for elective surgeries under spinal anaesthesia. MATERIALS AND METHODS: 60 non-diabetic adult patients of ASA Physical Status I and II posted for elective lower abdominal surgeries under spinal anaesthesia were randomly divided into two groups of 30 in each group. Group -R to receive Ringers lactate – 20 ml/kg and Group -H received 6% Hestar -10 ml /kg over half an hour prior to subarachnoid block as preloading fluid. Serial random glucose measurements were taken thereafter at specified time intervals upto 180 minutes. RESULTS: Group R (RL), maximal mean blood glucose levels of 94.72mg/dl were found at 60 mins from the onset of preloading indicating an increase of 12.8mg/dl from the baseline which was found to be statistically significant p=0.031 (p<0.05). This was followed by a gradual fall upto 93.88mg/dl at end of study period of 180 min. In Group-H the difference between the reading at the end of 180mins and the baseline was 13.88mg/dl and this difference was found to be still statistically significant p=0.022 (p<0.05). CONCLUSION: In addition to stress response to surgery, use of Ringers lactate and HES 6% significantly raised the blood sugar levels more with Hydroxyethyl Starch 6%. So their use in the perioperative period should be judicious as inadvertent usage can result in potential ill effects
