Effect of Using Ringer's Lactate, with and without Addition of Dextrose, on Intra-Operative Blood Sugar Levels in Infants Undergoing Facial Cleft Surgeries

BACKGROUND: Addition of glucose in the intraoperative fluid is a routine practice in infants. Under general anesthesia, due to neuroendocrine stress response, this could result in overt hyperglycemia. AIMS: The aim of this study was to find whether the addition of 2% dextrose to Ringer's lactate (RL) caused hyperglycemia compared to no addition of dextrose to RL. SETTINGS AND DESIGNS: This prospective randomized study was conducted in 100 infants undergoing facial cleft surgery at a tertiary care institution. SUBJECTS AND METHODS: Group D received RL with 2% dextrose and Group R received RL without the addition of dextrose. Blood sugars were measured at induction, 1 h and 2 h later. Hyperglycemia was defined as blood sugar >150 mg/dL and hypoglycemia as <70 mg/dL. STATISTICAL ANALYSIS USED: Pearson's Chi-square test, Paired t-test, Mann–Whitney test, and Independent sample t-test were used as applicable. RESULTS: Baseline blood sugar was comparable in both groups. A significant increase in blood sugar values from baseline was seen in both groups, but the increase was significantly more in Group D at 60 min (136.5 ± 41.9 vs. 109.2 ± 20.5) and at 120 min (150.1 ± 45.5 vs. 123.1 ± 31.7). The incidence of hyperglycemia was 50% in Group D and 12% in Group R. No patient developed hypoglycemia intraoperatively. No significant correlation between blood sugar and hours of fasting was established. CONCLUSION: Routine addition of dextrose to RL is not essential during short surgeries under general anesthesia in infants, provided preinduction blood sugar level is >70 mg/dL and intraoperative sugars are periodically monitored.