Postoperative glycemic control in head and neck surgery.

Area of Science:

• Anesthesiology
• Endocrinology
• Surgical Recovery

Background:

• Preoperative dexamethasone is used to prevent post-operative pain and nausea.
• Its impact on post-operative glycemic control and recovery requires further investigation.
• Clinical trial registration: NCT04021186.

Purpose of the Study:

• To investigate the effects of pre-operative dexamethasone on post-operative glycemic control.
• To assess the influence of glycemic control on patient recovery after head and neck surgery.
• To evaluate the necessity of standard protocols for managing post-operative insulin resistance.

Main Methods:

• Randomized controlled trial in hospitalized head and neck surgery patients.
• Continuous glucose monitoring using the Freestyle Libre system.
• Intervention group received insulin for hyperglycemia; control group did not.

Main Results:

• Hyperglycemia (blood glucose ≥10 mmol/L) observed in 54% of patients.
• Blood glucose normalized with small insulin doses; elevated p-C-peptide levels noted.
• No significant differences in maximum blood glucose, hospital stay, or readmissions between groups.

Conclusions:

• Postoperative hyperglycemia is common but manageable in head and neck surgery patients.
• Preoperative dexamethasone did not lead to significant insulin resistance.
• Standard postoperative protocols for hyperglycemia may not be indicated; frequent glucose monitoring is recommended.