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Is intraoperative supplementation of dextrose essential for infants undergoing facial cleft surgeries?
Sunil Rajan1, Kaushik Barua1, Pulak Tosh1
1Department of Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, India.
Insights
Adding 1% dextrose to Ringer
Area of Science:
- Pediatric Anesthesiology
- Neonatal Surgery
- Metabolic Studies
Background:
- Intraoperative maintenance fluids for pediatric patients often include dextrose.
- The use of dextrose in maintenance fluids for infants undergoing surgery requires careful consideration of blood glucose regulation.
Purpose of the Study:
- To determine the impact of adding 1% dextrose to Ringer's lactate (RL) on intraoperative blood glucose levels in infants undergoing facial cleft surgeries.
Main Methods:
- A prospective, randomized, single-blinded study involving forty infants undergoing cheiloplasty or palatoplasty.
- Random blood sugar (RBS) was measured using a glucometer at baseline, 1 hour, and 2 hours post-induction.
- Infants received either RL (Group R) or RL with 1% dextrose (Group D) as maintenance fluid.
Main Results:
- No significant difference in baseline, 60-minute, or 120-minute RBS levels between the Ringer's lactate (RL) and RL with dextrose groups.
- Both groups showed a significant increase in blood sugar levels from baseline.
- Hyperglycemia incidence was similar between groups, and no hypoglycemia occurred intraoperatively.
Conclusions:
- Intraoperative maintenance fluid with Ringer's lactate alone or with added 1% dextrose yields comparable blood glucose levels in infants undergoing facial cleft surgery.
- The addition of 1% dextrose to RL does not significantly alter intraoperative glycemia in this pediatric surgical population.
Background And Aims:
Dextrose is commonly added to the intraoperative maintenance fluids of pediatric patients. The primary objective was to evaluate the effect of addition of 1% dextrose to Ringer's lactate (RL) on blood glucose levels in infants undergoing facial cleft surgeries.
Material And Methods:
This prospective, randomized, single blinded study was conducted in forty infants undergoing either cheiloplasty or palatoplasty. Random blood sugar (RBS) was assessed using a glucometer after induction of anaesthesia, and at 1 and 2 hours later. Group R received RL and Group D received RL with 1% dextrose as intraoperative maintenance fluid. Hypoglycemia was defined as RBS <70 mg/dL and hyperglycemia as RBS >150 mg/dL.
Results:
Baseline RBS levels and those at 60 min and 120 min post-induction were comparable in both groups. The increase in blood sugar levels from baseline to 60 min and to 120 min in each group was significant. Incidence of hyperglycemia was comparable in both groups. There were no episodes of hypoglycemia, intraoperatively.
Conclusion:
Use of Ringer lactate alone or with addition of 1% dextrose resulted in comparable intraoperative blood sugar levels when used as maintenance fluid in infants undergoing facial cleft surgeries.
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