Intravenous bolus-infusion versus sliding scale of insulin for intra-operative glycemic control in elective laparotomy surgeries
Abstract Background The aim of this study was to assess the bolus-infusion to the sliding scale of insulin approaches, regarding percentage of the operative time with the target capillary blood glucose (CBG) range, total insulin units given to the patients, development of hypoglycemia, and the peri-...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-12-01
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| Series: | Ain Shams Journal of Anesthesiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s42077-022-00288-1 |
| _version_ | 1811315068309078016 |
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| author | Ghada M. Samir Mahmoud Abd El-Aziz Ghallab Dalia A. Ibrahim |
| author_facet | Ghada M. Samir Mahmoud Abd El-Aziz Ghallab Dalia A. Ibrahim |
| author_sort | Ghada M. Samir |
| collection | DOAJ |
| description | Abstract Background The aim of this study was to assess the bolus-infusion to the sliding scale of insulin approaches, regarding percentage of the operative time with the target capillary blood glucose (CBG) range, total insulin units given to the patients, development of hypoglycemia, and the peri-operative changes in serum potassium (s.k) in elective laparotomy surgeries. Sixty patients, American Society of Anesthesiologists (ASA) physical status II, were randomly divided to either the bolus-insulin infusion (BII) group, or the sliding scale of insulin (SSI) group. Results The intra-operative target CBG range was achieved in both groups, with no statistically significant difference between them. However, in the post anesthesia care unit (PACU), the number of patients who achieved the target CBG range was significantly more in the BII group. The decrease in the CBG was statistically significant in the SSI group than in the BII group; starting from 30 minutes after the initial intra-venous (IV) insulin injected, to 240 minutes intra-operatively and in the PACU. No patient in either groups developed hypoglycemia. The mean intra-operative time needed to achieve the target CBG range was statistically significant less in the SSI group. The mean percentage of the operative time with the target CBG range was statistically non-significant higher in the SSI group. The mean total insulin units given were statistically non-significant higher in the SSI group. The peri-operative changes in s.k were statistically non-significant between the two groups. Conclusions The BII approach slowly achieved the target CBG range intra-operatively and maintained this target in the PACU, with mean 54.6 ± 28.9% operative time with the target CBG range, and with less mean total insulin units needed than the SSI approach. |
| first_indexed | 2024-04-13T11:23:41Z |
| format | Article |
| id | doaj.art-d40118f94afa482e8a404288eb06b74d |
| institution | Directory Open Access Journal |
| issn | 2090-925X |
| language | English |
| last_indexed | 2024-04-13T11:23:41Z |
| publishDate | 2022-12-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Ain Shams Journal of Anesthesiology |
| spelling | doaj.art-d40118f94afa482e8a404288eb06b74d2022-12-22T02:48:45ZengSpringerOpenAin Shams Journal of Anesthesiology2090-925X2022-12-0114111010.1186/s42077-022-00288-1Intravenous bolus-infusion versus sliding scale of insulin for intra-operative glycemic control in elective laparotomy surgeriesGhada M. Samir0Mahmoud Abd El-Aziz Ghallab1Dalia A. Ibrahim2Department of Anesthesia, Intensive Care and Pain Management, Ain Shams UniversityDepartment of Anesthesia, Intensive Care and Pain Management, Ain Shams UniversityDepartment of Anesthesia, Intensive Care and Pain Management, Ain Shams UniversityAbstract Background The aim of this study was to assess the bolus-infusion to the sliding scale of insulin approaches, regarding percentage of the operative time with the target capillary blood glucose (CBG) range, total insulin units given to the patients, development of hypoglycemia, and the peri-operative changes in serum potassium (s.k) in elective laparotomy surgeries. Sixty patients, American Society of Anesthesiologists (ASA) physical status II, were randomly divided to either the bolus-insulin infusion (BII) group, or the sliding scale of insulin (SSI) group. Results The intra-operative target CBG range was achieved in both groups, with no statistically significant difference between them. However, in the post anesthesia care unit (PACU), the number of patients who achieved the target CBG range was significantly more in the BII group. The decrease in the CBG was statistically significant in the SSI group than in the BII group; starting from 30 minutes after the initial intra-venous (IV) insulin injected, to 240 minutes intra-operatively and in the PACU. No patient in either groups developed hypoglycemia. The mean intra-operative time needed to achieve the target CBG range was statistically significant less in the SSI group. The mean percentage of the operative time with the target CBG range was statistically non-significant higher in the SSI group. The mean total insulin units given were statistically non-significant higher in the SSI group. The peri-operative changes in s.k were statistically non-significant between the two groups. Conclusions The BII approach slowly achieved the target CBG range intra-operatively and maintained this target in the PACU, with mean 54.6 ± 28.9% operative time with the target CBG range, and with less mean total insulin units needed than the SSI approach.https://doi.org/10.1186/s42077-022-00288-1Bolus insulin infusionSliding scale insulinIntra-operative glycemic controlPeri-operative serum potassium |
| spellingShingle | Ghada M. Samir Mahmoud Abd El-Aziz Ghallab Dalia A. Ibrahim Intravenous bolus-infusion versus sliding scale of insulin for intra-operative glycemic control in elective laparotomy surgeries Ain Shams Journal of Anesthesiology Bolus insulin infusion Sliding scale insulin Intra-operative glycemic control Peri-operative serum potassium |
| title | Intravenous bolus-infusion versus sliding scale of insulin for intra-operative glycemic control in elective laparotomy surgeries |
| title_full | Intravenous bolus-infusion versus sliding scale of insulin for intra-operative glycemic control in elective laparotomy surgeries |
| title_fullStr | Intravenous bolus-infusion versus sliding scale of insulin for intra-operative glycemic control in elective laparotomy surgeries |
| title_full_unstemmed | Intravenous bolus-infusion versus sliding scale of insulin for intra-operative glycemic control in elective laparotomy surgeries |
| title_short | Intravenous bolus-infusion versus sliding scale of insulin for intra-operative glycemic control in elective laparotomy surgeries |
| title_sort | intravenous bolus infusion versus sliding scale of insulin for intra operative glycemic control in elective laparotomy surgeries |
| topic | Bolus insulin infusion Sliding scale insulin Intra-operative glycemic control Peri-operative serum potassium |
| url | https://doi.org/10.1186/s42077-022-00288-1 |
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