Variations in Levels of Blood Sugar and Anti-Inflammatory Mediators Following Dexamethasone in Neurosurgical Patients

Improvement in neurological status following dexamethasone administration is dramatic. However, it has the potential to cause hyperglycaemia and anti-inflammatory effects.

The present study was planned to evaluate the variations in blood glucose levels and anti-inflammatory mediators in response to a single dose of dexamethasone in neurosurgical patients.

The present prospective, non-randomized, double-blind, placebo-controlled study was conducted in sixty-four adult patients of either sex, belonging to ASA I to III, scheduled to undergo elective craniotomy under GA. A standard protocol for induction of anaesthesia was followed. The decision to administer 8mg dexamethasone was taken by the operating surgeon and consultant anaesthesiologist, depending upon the need, administered at the time of dural incision. Patients were divided into 3 groups: DD- patients already on dexamethasone and receiving intraoperatively, ND - not on dexamethasone but receiving intraoperatively, and NN- neither on dexamethasone nor receiving intraoperatively. Venous sample was taken for blood sugar estimation at 1hr, 2hr, 3hr, and 4hr after administrating dexamethasone, then every 4 hrs till 24 hrs. WBC count with neutrophil percentage, haematocrit, serum lactate and C-reactive protein was measured at baseline, 12 hours and 24 hours. All three groups showed a rise in blood glucose, peaking at 4 hours and returning to baseline values at 24 hours. A significant difference in anti-inflammatory mediators was seen in group DD.

Single dose of dexamethasone administered intraoperatively induces an increase in blood sugar levels and changes in anti-inflammatory mediator.