Exp Clin Endocrinol Diabetes 2010; 118(3): 190-194
DOI: 10.1055/s-0029-1237381
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Thoracic Epidural Anesthesia and Blood Glucose Levels in Diabetic Patients Undergoing Cardiopulmonary Bypass Under Insulin Infusion According to the Portland Protocol

M. Sener1 , E. Caliskan1 , N. Bozdogan1 , A. Kocum1 , S. O. Oner1 , H. Atalay2 , Z. Kayhan1
  • 1Department of Anesthesiology and Reanimation, Baskent University Faculty of Medicine, Ankara, Turkiye
  • 2Department of Cardiovascular Surgery, Baskent University Faculty of Medicine, Ankara, Turkiye
Further Information

Publication History

received 03.03.2009 first decision 16.06.2009

accepted 29.07.2009

Publication Date:
15 October 2009 (online)

Abstract

Background: We investigated the effect of thoracic epidural anesthesia on perioperative blood glucose levels in diabetic patients undergoing cardiopulmonary bypass by continuous insulin infusion according to the Portland Protocol.

Material and Methods: Diabetic patients undergoing surgery with cardiopulmonary bypass were assigned to receive either general anesthesia alone (n=40) or general anesthesia with thoracic epidural anesthesia (n=18). Patient data were retrospectively reviewed from prospective chart records used in our anesthesia clinic. In all study patients, insulin infusion with the Portland Protocol was used to maintain stable blood glucose levels. We evaluated blood glucose levels in both groups at 6 time points including before surgery, before cardiopulmonary bypass, during cardiopulmonary bypass, immediately following cardiopulmonary bypass, and on the first and second postoperative days. The amounts of insulin required at the intraoperative period and during two postoperative days were compared between two groups.

Results: Groups were similar with respect to the duration of cardiopulmonary bypass, aortic cross-clamping, surgery, and blood glucose levels at any of the 6 time points, mean insulin requirements during intraoperative period and mean insulin requirements and blood glucose levels during the first 2 postoperative days (General anesthesia alone, 189±29 mg/dl vs. General anesthesia with thoracic epidural anesthesia, 191±19 mg/dl; p=0.782).

Conclusions: In diabetic patients undergoing cardiopulmonary bypass receiving insulin infusion by the Portland Protocol for glycemic control, thoracic epidural anesthesia provides no additional benefit for maintaining blood glucose levels during surgery.

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Correspondence

M. SenerMD (Associate Professor) 

Baskent Universitesi Adana Seyhan Hastanesi

Anesteziyoloji ve Reanimasyon AD

Baraj yolu 1. durak no: 37

TR01140 Seyhan/Adana

Turkiye

Phone: +90/322/458 68 68–12 26

Fax: +90/322/45 926 22

Email: mesutsenertr@yahoo.co.uk

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