당일 수술을 시행 받는 환아에서 수액이 혈당에 미치는 영향

초록

Background: Whether intraoperative fluid therapy should contain glucose for the pediatric outpatient surgery remains controversial. This study was designed to compare the effects of glucose and glucose-free solutions on perioperative blood glucose change. Methods: Healthy pediatric outpatients (n = 130) for minor procedure were randomly assigned to one of two fluid therapy groups. Patients in the group H (n = 65) received lactated Ringer's solution, and patients in the group D (n = 65) received 5% dextrose perioperatively. Blood glucose was checked before infusion (a), 10 minutes after induction (b), 30 minutes after induction (c), and at the time of discharge (d). Results: The preoperative fasting glucose concentrations were 97.6 ± 12.1 mg/dl and 97.7 ± 11.3 mg/dl for the group H and D, respectively. The patients in the group D showed significantly increased blood glucose level after induction (135.9 ± 42.7, 150.3 ± 36.0, 123.6 ± 26.8 mg/dl). The patients in the group H also showed significantly increased blood glucose levels (112.2 ± 14.0, 121.4 ± 11.4 and 105.8 ± 18.3 mg/dl). The glucose level of group D was significantly higher than the glucose level of group H at b, c and d. Seven patients in the group D showed hyperglycemia (＞ 200 mg/dl). Conclusions: Dextrose containing fluid therapy resulted dangerous hyperglycemia in the pediatric outpatient surgery. We recommend lactated Ringer's solution or other glucose-free crystalloid for the healthy outpatient pediatric population undergoing minor procedures. (Korean J Anesthesiol 2006; 50: 158～61)

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