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A study of blood glucose in paediatric laparoscopy
N Dave1, M A H Khan, A R Halbe
1BYL Nair Charitable Hospital, Mumbai, India. nandini_dave@rediffmail.com
Insights
Pediatric laparoscopic surgery causes a blood glucose rise similar to open surgery. Dextrose-containing intravenous solutions exacerbate this hyperglycemic response in children.
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Metabolic Response
Background:
- Limited research exists on pediatric stress responses during laparoscopic surgery.
- Assessing blood glucose changes in children undergoing laparoscopy is crucial.
- Investigating the impact of intravenous fluid types on blood glucose in pediatric surgical procedures.
Purpose of the Study:
- To evaluate blood glucose levels in children during laparoscopic surgery.
- To compare the effects of dextrose normal saline (DS) and Ringer's lactate (RL) on blood glucose.
- To analyze glucose response in both open and laparoscopic procedures.
Main Methods:
- 120 healthy children (2-12 years) were randomized to receive DS or RL.
- Blood glucose was measured pre-infusion and 1 hour post-induction/insufflation.
- Comparison between open and laparoscopic surgery, and between fluid types.
Main Results:
- All groups showed increased blood glucose post-induction.
- Ringer's lactate led to higher 1-hour glucose in laparoscopy vs. open surgery.
- Dextrose normal saline showed a significantly higher 1-hour glucose in the laparoscopy group.
Conclusions:
- Laparoscopic surgery in children induces a blood glucose increase comparable to open surgery.
- Peri-operative infusion of dextrose-containing solutions potentiates the hyperglycemic response.
- Fluid choice significantly impacts blood glucose levels in pediatric surgical patients.
Background:
There are few studies on stress responses to laparoscopic surgery in children. This study was conducted to assess the blood glucose levels in children undergoing laparoscopy. We also studied the effect of two different intravenous (i.v.) solutions on blood glucose in open and laparoscopic procedures.
Methods:
One hundred and twenty healthy children, aged 2-12 years, undergoing either open or laparoscopic surgery, were randomized to receive either dextrose normal saline (DS) or Ringer's lactate peri-operatively (RL). All patients had blood glucose measurements performed immediately after induction but prior to the i.v. infusion of any fluid. Blood glucose was again measured 1 h after induction in the open cases and 1 h after insufflation in the laparoscopy cases.
Results:
In the groups, baseline blood glucose values were comparable. In all groups, blood glucose concentrations increased from the immediate post-induction (baseline) values. When RL was infused, the 1-h blood glucose was higher in the laparoscopy group as compared with the open group. However, when DS was infused the difference between the 1-h blood glucose in the open and laparoscopic procedures was not statistically significant. In the laparoscopy group, the 1-h blood glucose value was significantly higher in the patients receiving dextrose solution.
Conclusion:
Laparoscopic procedures in children are associated with a rise in blood glucose levels similar to open surgery. The hyperglycaemic response was more pronounced when dextrose-containing solutions were infused peri-operatively.
