Impact of Intravenous Propofol and Intravenous Etomidate as Induction Agents on Intraoperative Blood Glucose Levels in Elective Surgical Procedures Under General Anesthesia: A Randomized Controlled Trial

Abstract

Background: Major surgical procedures can often trigger acute hyperglycemia, which, even if it’s brief, can result in a weakening of the immune system [1]. Surgeries necessitating general anesthesia are particularly susceptible to stress- related immune system suppression and a rise in blood sugar levels during the procedure. The drugs administered during the induction and maintenance of anesthesia are also recognized for their potential to disrupt normal blood glucose levels, further contributing to the overall stress response associated with surgery, which can subsequently increase the risk of postoperative complications [2], [3]. Material and methods: Fifty cases, all falling within the American Society of Anesthesiology’s class 1 and 2 categories, were included in this study. These patients underwent preoxygenation and received premedication drugs, followed by anesthesia induction using either Propofol at a dosage of 2 mg/kg or Etomidate at 0.3 mg/kg. Blood glucose levels were monitored at three specific time points: before premedication, at the 6th minute, and at the 15th minute post-induction. Statistical analysis was performed using the Student t-test for continuous scale parameters and the Chi-square test for categorical scale parameters. A p-value less than 0.05 was considered statistically significant. Results: In the Etomidate Group, there was a notable increase in blood glucose levels when compared to the premedication values (80.7     14.37 to 90.5     18.09), and this increase was statistically significant (p-value 0.0165). Conversely, in the Propofol Group, the variation in blood glucose levels was not statistically significant (86.26    15.27 to 84.05     12.64). Conclusion: In this study, it was observed that the rise in blood glucose levels in non-diabetic patients following anesthesia induction was notably higher when using Etomidate compared to Propofol.