Effect of 6% hydroxyethyl starch-450 and low molecular weight dextran on blood sugar levels during surgery under subarachnoid block: A prospective randomised study

Dextrans and hydroxyethyl starches produce significant levels of free glucose residues following metabolism. The following study was designed to compare 6% hydroxyethyl starch-450 with Dextran 40, both used as preloading fluids, for their potential to raise peri-operative blood glucose levels. After taking an informed consent, 180 non-diabetic adult patients, posted for elective surgery under spinal anaesthesia, were randomly divided into three groups, to receive Ringer’s Lactate 20 ml/kg (group 1), Dextran 40,10 ml/kg (group 2) and Hestar 6%-450, 10 ml/kg (group 3), over half an hour, prior to the subarachnoid block, as preloading fluid, and serial capillary blood glucose measurements were taken thereafter at regular intervals up to 240 minutes from the baseline reading. All the three preloading fluids, including Ringer’s Lactate used as control, were seen to significantly increase the capillary blood glucose levels intra-operatively (P < 0.05), but the rise with Dextran-40 was seen to be sustained and highly significant (P < 0.001). We thus conclude that, Dextran40 causes a sustained and significant rise in peri-operative blood glucose levels.