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Blood-glucose concentrations during anaesthesia in children. Effects of starvation and perioperative fluid therapy
Insights
Preoperative starvation in children did not lead to hypoglycemia. Even without glucose infusions during surgery, blood glucose levels increased, suggesting endogenous glucose production.
Area of Science:
- Pediatric Anesthesiology
- Pediatric Critical Care
- Pediatric Endocrinology
Background:
- Perioperative fluid management is critical in pediatric surgery.
- Understanding glucose homeostasis in infants and children is essential.
- Prolonged starvation can pose risks for glucose regulation in young children.
Purpose of the Study:
- To investigate blood glucose concentrations in anesthetized children before and after surgery.
- To assess the impact of preoperative starvation on glucose levels.
- To evaluate the effect of intraoperative fluid regimens on blood glucose.
Main Methods:
- Measurement of blood glucose, pH, and standard bicarbonate in 70 anesthetized children (2 weeks to 22 months).
- Data collected pre- and post-operatively.
- Children received either Ringer acetate or Ringer glucose solution during surgery.
Main Results:
- Preoperative blood glucose levels were not significantly affected by age, weight, or starvation duration.
- No instances of preoperative hypoglycemia were observed.
- Intraoperative blood glucose levels increased even in children receiving glucose-free fluids.
Conclusions:
- Preoperative starvation does not appear to cause hypoglycemia in this pediatric surgical population.
- Children exhibit robust glucose regulation during surgery, even without exogenous glucose administration.
- Endogenous glucose production likely compensates for fasting in this age group.
Abstract:
Blood glucose concentration, pH and standard bicarbonate concentration were measured in 70 anaesthetized children aged between 2 weeks and 22 months before and following surgery. The duration of starvation varied between 4 and 14 h (mean 5.8 h). The lowest blood-glucose concentration before operation was 2.9 mmol litre-1 (53 mg dl-1). Preoperative blood-glucose concentrations were not influenced by the age or weight of the child, or the duration of starvation. During operation the children received either a balanced Ringer acetate solution (group A) or a Ringer glucose solution containing 2.5% glucose (group B). In these patients the preoperative starvation did not result in hypoglycaemia and, during surgery, increases in blood-glucose concentration were found even in those children receiving a glucose-free fluid regimen.