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Original ArticleOpen Access
Effect of Intraoperative Fluid on Blood Glucose Level in Neurosurgery
lttichaikulthol W 
,
Lekprasert V ,
Pausawasdi S ,
Suchartwatnachai P
,
Lekprasert V ,
Pausawasdi S ,
Suchartwatnachai P There is a considerable controversy regarding glucose administration during intracranial
surgery. However, recent animal and human studies suggest that hyperglycemia exacerbates
ischemic brain damage and intraoperative hypoglycemia may not be a concern if the surgical
procedure is less than 4 hours.
We, therefore, studied the blood glucose in neurosurgery with craniotomy in 90 Thai
patients, divided into 3 groups. 30 patients in each group received balanced salt solution (0.9%
NSS), 5 per cent glucose rate 60-80 ml/h and 5 per cent glucose rate more than 120 ml!h.
Blood for the determination of glucose concentration was obtained after induction and every 2
hours later until the end of the surgery.
There was one male patient in group I who received balanced salt solution (0.9% NSS) had
blood glucose concentration lowered to 57 mg% at 4 hours after induction. The patients in group
II who received 5 per cent glucose solution at maintenance rate did not have hyperglycemia
(161.20±38.30 mg%). In group III ; patients given 5 per cent glucose infusion at the rate of more
than 120 ml/h had hyperglycemia (236.75±63.57 mg%) at 6 hours. In conclusion, we suggest
that in Thai patients undergoing neurosurgical procedures; blood glucose levels should be checked
intraoperatively if glucose is withheld from the intraoperative fluid regimen. Otherwise 80 ml/h
of 5 per cent dextrose intravenous infusion should be given to the patients to prevent hypoglycemia.
surgery. However, recent animal and human studies suggest that hyperglycemia exacerbates
ischemic brain damage and intraoperative hypoglycemia may not be a concern if the surgical
procedure is less than 4 hours.
We, therefore, studied the blood glucose in neurosurgery with craniotomy in 90 Thai
patients, divided into 3 groups. 30 patients in each group received balanced salt solution (0.9%
NSS), 5 per cent glucose rate 60-80 ml/h and 5 per cent glucose rate more than 120 ml!h.
Blood for the determination of glucose concentration was obtained after induction and every 2
hours later until the end of the surgery.
There was one male patient in group I who received balanced salt solution (0.9% NSS) had
blood glucose concentration lowered to 57 mg% at 4 hours after induction. The patients in group
II who received 5 per cent glucose solution at maintenance rate did not have hyperglycemia
(161.20±38.30 mg%). In group III ; patients given 5 per cent glucose infusion at the rate of more
than 120 ml/h had hyperglycemia (236.75±63.57 mg%) at 6 hours. In conclusion, we suggest
that in Thai patients undergoing neurosurgical procedures; blood glucose levels should be checked
intraoperatively if glucose is withheld from the intraoperative fluid regimen. Otherwise 80 ml/h
of 5 per cent dextrose intravenous infusion should be given to the patients to prevent hypoglycemia.
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