Effect of 4% gelatin and dextran-40 on blood glucose levels during surgery under subarachnoid block

Background & Aims: Stress response to surgery induces hyperglycemia to limited extent. An additive hyperglycemic response, secondary to the metabolism of intravenous fluids, can thus prove detrimental to the well-being of the patient, if ignored. Our study aimed to examine and compare the effects of 4% gelatin and dextran-40 on blood glucose levels during surgery under subarachnoid block and their potential to induce hyperglycemia. Methods: Sixty ASA grade I and II patients were randomized into two groups, 30 patients in each. Group 1 patients were preloaded with 4% Gelatin (10ml/kg) and Group 2 patients were preloaded with Dextran-40 in normal saline (10ml/kg), over a period of 30 minutes (min). Just prior to preloading, base line capillary blood glucose (CBG) level was noted this is followed by subsequent readings at 20 min interval until 100 min from base line reading. All patients received normal saline (0.9%) as a maintenance fluid. Under strict aseptic precautions, subarachnoid block using 15 mg of hyperbaric bupivacaine at L3-L4 or L4-L5 level was given after preloading. Results: Both groups are comparable in age, weight, sex and age wise distribution. The CBG levels in both the groups were within physiological limits. In group 2, the maximum mean blood glucose level of 94.53 ± 14.57 mg/dL was found at 60 min from onset of preloading, which was found to be statistically significant (p=0.017), when compared with corresponding blood glucose level (86.50 ± 10.44mg/dL) in group 1. Conclusion: Preloading the patients prior to subarachnoid block with 4% gelatin or dextran 40 do not raise CBG levels significantly above the physiological limits.