Dexametasona para profilaxis de náuseas y vómitos postoperatorios: efecto sobre la glicemia en pacientes con diabetes mellitus tipo 2 y en no diabéticos sometidos a cirugía laparoscópica
Background: Postoperative nausea and vomiting (PONV) prophylaxis with dexamethasone may produce significant hyperglycemia in the postoperative period. Aim: To evaluate if this effect is of greater severity in type 2 diabetics compared with non-diabetic patients. Material and Methods: Forty non-diabe...
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| Autores principales: | , , , , |
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| Lenguaje: | Spanish / Castilian |
| Publicado: |
Sociedad Médica de Santiago
2011
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| Materias: | |
| Acceso en línea: | http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872011000600009 |
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| Sumario: | Background: Postoperative nausea and vomiting (PONV) prophylaxis with dexamethasone may produce significant hyperglycemia in the postoperative period. Aim: To evaluate if this effect is of greater severity in type 2 diabetics compared with non-diabetic patients. Material and Methods: Forty non-diabetic and thirty type 2 diabetic patients undergoing laparoscopic cholecystectomy were studied in a prospective and double-blind fashion manner. Patients were randomly distributed into 4 groups: Group I, non-diabetics control (n = 20), Group II, non-diabetics dexamethasone (n = 20), Group III, type 2 diabetics control (n = 15), and Group I V, type 2 diabetics dexamethasone (n = 15). Immediately after induction, patients in groups I and III received isotonic saline and patients in the dexamethasone groups received 8 mg iv of the steroid. Capillary blood glucose concentrations were measured at baseline and every 2 hours during the first 12 hours since the start of surgery. A linear mixed effect model, adjusted for baseline capillary glucose concentration, age and duration of surgery was used to analyze the data. Results: No effect of the presence of diabetes mellitus was observed in the evolution of glucose concentrations. There was a difference in capillary glucose concentrations between patients who received dexamethasone and placebo that started 2 hours post-intervention, reaching a mean maximum difference of 34 mg/dl (adjusted model, p < 0.001) at 10 hours post-intervention. Conclusions: In this study, Type 2 diabetic patients did not show a higher susceptibility than non-diabetics to develop postoperative hyperglycemia after the use of prophylactic dexamethasone for PONV. |
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