Blood glucose changes during neurosurgery

Blood glucose levels were studied prospectively in 40 patients undergoing elective major craniotomy. A significant (p less than 0.01) hyperglycaemic response was noted after scalp infiltration with adrenaline and incision (0.5 mmol/l) and with continued surgery (0.9 mmol/l). Patients aged 50 years and under showed a significantly greater rise with adrenaline and incision than older patients (0.8 compared with 0.4 mmol/l p less than 0.01). Preoperative high dose steroid therapy did not modify the response. Blood glucose changes were unrelated to sex, obesity, a family history of diabetes, the duration of starvation, intraoperative body temperature, anaesthetic technique, induced hypotension or blood loss.