Yeungnam Univ J Med.  2018 Jun;35(1):54-62. 10.12701/yujm.2018.35.1.54.

Comparison of sevoflurane and propofol anesthesia on the incidence of hyperglycemia in patients with type 2 diabetes undergoing lung surgery

• Kim H
• Han J
• Jung SM
• Park SJ
• Kwon NK

• KMID: 2415734
• DOI: http://doi.org/10.12701/yujm.2018.35.1.54

Abstract

BACKGROUND
The type and regimen of anesthesia may affect perioperative hyperglycemia following major surgical stress. This study compared the effects of sevoflurane and propofol on the incidence of hyperglycemia and clinical outcomes in diabetic patients undergoing lung surgery.
METHODS
This retrospective study included 176 patients with type 2 diabetes mellitus who had undergone lung surgery. Blood glucose levels and clinical outcomes from the preoperative period to the first 2 postoperative days (PODs) were retrospectively examined in patients who received sevoflurane (group S, n= 87) and propofol (group P, n=89) for maintenance of general anesthesia. The primary endpoint was the incidence of persistent hyperglycemia (2 consecutive blood glucose levels > 180 mg/dL [10.0 mmol/L]) during the perioperative period. The secondary composite endpoint was the incidence of major postoperative complications and 30-day mortality rate after surgery.
RESULTS
Blood glucose levels similarly increased from the preoperative period to the second POD in both groups (p=0.857). Although blood glucose levels at 2 hours after surgery were significantly lower in group P than in group S (p=0.022; 95% confidence interval for mean difference, −27.154 to −2.090), there was no difference in the incidence of persistent hyperglycemia during the perioperative period (group S, 70%; group P, 69%; p=0.816). The composite of major postoperative complications and all-cause in-hospital and 30-day mortality rates were also comparable between the two groups.
CONCLUSION
Sevoflurane and propofol were associated with a comparable incidence of perioperative hyperglycemia and clinical outcomes in diabetic patients undergoing lung surgery.

Keyword

Diabetes mellitus; General anesthesia; Lung surgery; Propofol; Sevoflurane

MeSH Terms

Anesthesia*
Anesthesia, General
Blood Glucose
Diabetes Mellitus
Diabetes Mellitus, Type 2
Humans
Hyperglycemia*
Incidence*
Lung*
Mortality
Perioperative Period
Postoperative Complications
Preoperative Period
Propofol*
Retrospective Studies
Blood Glucose
Propofol

Figure

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  Fig. 1. Flow chart of the study design. DM, diabetes mellitus; Group P, propofol; Group S, sevoflurane.

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  Fig. 2. Incidence of hyperglycemia during the perioperative period. Numbers are expressed as percentages of hyperglycemic patients. Group P, propofol; Group S, sevoflurane; Preop, before surgery; Intraop, during surgery; POH, postoperative hour; POD, postoperative day.

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