مجله علوم پزشکی پارس

مقایسه میزان نوسانات قند خون بیماران غیردیابتی حین عمل جراحی ارتوپدی در دو روش بی هوشی عمومی و بی حسی نخاعی

نویسندگان

1 استادیار غدد درون ریز و متابولیسم، دانشگاه علوم پزشکی جهرم،جهرم، ایران

2 دانشیارگروه بیهوشی،دانشگاه علوم پزشکی تهران،تهران، ایران

3 دانشجو پزشکی،کمیته تحقیقات دانشجویی، دانشگاه علوم پزشکی جهرم،جهرم، ایران

4 دانشیار گروه بیهوشی،دانشگاه علوم پزشکی جهرم،جهرم، ایران

5 مربی،مرکز تحقیقات مولفه های اجتماعی نظام سلامت،دانشگاه علومپزشکی جهرم،جهرم، ایران

چکیده

مقدمه: یکی از پاسخ های متابولیک به استرس های جراحی، ایجاد تغییرات در مقدار سرمی قند بیمار تحت عمل جراحی است. از این رو، این مطالعه با هدف مقایسه میزان نوسان قند خون بیماران غیر دیابتی حین عمل جراحی ارتوپدی در دو روش بی هوشی عمومی و
بی حسی نخاعی انجام شد.
روش کار:  در این مطالعه تحلیلی- مقطعی، 60 بیمار با کلاس بی هوشی 1و 2 تحت عمل جراحی ارتوپدی با روش بی هوشی عمومی و بی حسی نخاعی قرار گرفتند. بیماران به دو گروه، بی هوشی عمومی و بی حسی نخاعی تقسیم شدند. برای اندازه گیری قند خون بیماران از دستگاه گلوکومتر استفاده شد. علائم همودینامیک و میزان لرز بیماران نیز مورد بررسی قرار گرفت.
یافته ها: میانگین قند خون بین دو گروه بی‌حسی نخاعی و بی هوشی عمومی در زمان های  قبل از عمل، بعد از بی حسی نخاعی یا
بی هوشی عمومی، در زمان 30 دقیقه و  60 دقیقه بعد از عمل و در ریکاوری تفاوت معناداری را نشان نداد (P >0.05). مقایسه های درون گروهی با آزمون تحلیل واریانس با اندازه گیری های تکراری نشان داد که روند میانگین قند خون در این زمان ها، تنها در گروه‌ بی‌حسی نخاعی معنادار است (P =0.006).
نتیجه‌گیری: با توجه به اهمیت تنظیم قند خون در حوالی زمان جراحی، مطالعه حاضر بی حسی نخاعی را در کنترل قند خون بیماران تا حدودی نسبت به بی هوشی عمومی ارجح  دانست، اما تایید این یافته نیازمند مطالعات دقیق تری است.

کلیدواژه‌ها

عنوان مقاله [English]

Comparison of blood sugar fluctuations in non-diabetic patients during orthopedic surgery in general anesthesia and spinal anesthesia

نویسندگان [English]

  • Fatemeh Eftekharian 1
  • Mahdi Sanatkar 2
  • Zahra Eslami 3
  • Ali Fadaei 3
  • Mohammad Sadegh Sanie Jahromi 4
  • Navid Kalani 5

1 Assistant Professor of Endocrinology & Metabolism, Jahrom University of Medical Sciences, Iran, Iran

2 Associate Professor of Anesthesiology, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran

3 Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran.

4 Associate Professor of Anesthesiology, Jahrom University of Medical Sciences, Iran, Iran

5 Research center for social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran

چکیده [English]

Introduction: One of the metabolic responses to surgical stress is changes in serum glucose levels of patients undergoing surgery. Therefore, the aim of this study was to compare the blood sugar fluctuations of non-diabetic patients during orthopedic surgery in general anesthesia and spinal anesthesia.
Materials and Methods: In this cohort study, 60 patients with anesthesia classes 1 and 2 underwent orthopedic surgery under general anesthesia and spinal anesthesia. Patients were divided into 2 groups: general anesthesia and spinal anesthesia. A glucometer was used to measure patients' blood sugar. Hemodynamic symptoms and chills were also assessed.
Results: Mean BS showed no significant difference between spinal anesthesia and general anesthesia groups in preoperative times, after spinal anesthesia or general anesthesia, at 30 minutes and 60 minutes postoperatively and in recovery (p> 0.05). Intra-group comparisons with analysis of variance with repeated measures showed that the mean trend of BS at the time of the study was significant only in the spinal anesthesia group (p = 0.006). The mean trend of BS in the spinal anesthesia group was reduced in the postoperative period compared to the preoperative period.
Conclusion: Considering the importance of regulating blood sugar around surgery, the present study preferred spinal
anesthesia to control the patient's blood sugar to some extent over general anesthesia; but confirmation of this finding requires more detailed studies.

کلیدواژه‌ها [English]

  • Blood Sugar
  • General Anesthesia
  • Spinal Anesthesia
  • Non-Diabetic Patients
  • Orthopedics
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مجله علوم پزشکی پارس
دوره 19، شماره 4 - شماره پیاپی 58
دی 1400
صفحه 26-35