Changes in blood glucose level during and after light sedations using propofol-fentanyl and midazolam-fentanyl in diabetic patients who underwent cataract surgery


1 School of Medicine, Department of Anesthesiology, Feiz Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Anesthesiology, Feiz Hospital, Isfahan University of Medical Sciences, Isfahan, Iran


Background: Surgeries may trigger the stress response which leads to changes in blood glucose level, and studies suggest that different sedation and anesthesia methods have different effects on blood glucose level. The aim of this study was to investigate changes of blood glucose levels in diabetic patients and compare them in two sedation methods of propofol + fentanyl and midazolam + fentanyl.
Materials and Methods: Totally, 80 diabetic candidates for cataract surgery who had all the inclusion criteria, underwent cataract surgery using two methods of propofol (1 mg/kg/h) + fentanyl (2 μg/kg) (Group P) and midazolam (0.03 mg/kg) + fentanyl (2 μg/kg) (Group M) for light sedation. In the end, 70 patients (Group P n = 35 and Group M n = 35) remained in the study. Patients' blood glucose levels, vital signs, and hemodynamic data were assessed 30 min prior to the surgery, each 15 min during surgery and at the end of surgery.
Results: Hemodynamic parameters did not have a statistically significant difference between the two groups mean blood glucose level in Group M was 149.15 mg/dl and in Group P was 149.2 mg/dl, and based on repeated measures analysis of variance test, significant differences were not observed between the two groups (P = 0.99). T-test showed no significant differences in the blood glucose level at any time of the study between the two groups.
Conclusions: Light sedation methods of propofol + fentanyl and midazolam + fentanyl did not have any differences in alteration of blood glucose level.


Forouhi NG, Wareham NJ. Epidemiology of diabetes. Medicine (Abingdon) 2014;42:698-702.  Back to cited text no. 1
Levetan CS, Passaro M, Jablonski K, Kass M, Ratner RE. Unrecognized diabetes among hospitalized patients. Diabetes Care 1998;21:246-9.  Back to cited text no. 2
Chuah LL, Papamargaritis D, Pillai D, Krishnamoorthy A, le Roux CW. Morbidity and mortality of diabetes with surgery. Nutr Hosp 2013;28 Suppl 2:47-52.  Back to cited text no. 3
Lopes RD, Albrecht A, Williams J, Li S, Ferguson T, Kalil R, et al. Postoperative glucose control following coronary artery bypass graft surgery: Predictors and clinical outcomes. J Am Coll Cardiol 2013;61:10S.  Back to cited text no. 4
Leslie K, Troedel S. Does anaesthesia care affect the outcome following craniotomy? J Clin Neurosci 2002;9:231-6.  Back to cited text no. 5
Geisser W, Schreiber M, Hofbauer H, Lattermann R, Fussel S, Wachter U, et al. Sevoflurane versus isofluran - Anaesthesia for lower abdominal surgery. Effects on perioperative glucose metabolism. Acta Anaesthesiol Scand 2003;47:174-9.  Back to cited text no. 6
Desborough JP. The stress response to trauma and surgery. Br J Anaesth 2000;85:109-17.  Back to cited text no. 7
Kitamura T, Kawamura G, Ogawa M, Yamada Y. Comparison of the changes in blood glucose levels during anesthetic management using sevoflurane and propofol. Masui 2009;58:81-4.  Back to cited text no. 8
Cok OY, Ozkose Z, Pasaoglu H, Yardim S. Glucose response during craniotomy: Propofol-remifentanil versus isoflurane-remifentanil. Minerva Anestesiol 2011;77:1141-8.  Back to cited text no. 9
Masoumi G, Frasatkhish R, Jalali A, Ziyaeifard M, Sadeghpour-Tabae A, Mansouri M. Effects of moderate glycemic control in type II diabetes with insulin on arterial blood gas parameters following coronary artery bypass graft surgery. Res Cardiovasc Med 2014;3:e17857.  Back to cited text no. 10
Nascimento MA, Lira RP, Kara-José N, Arieta CE. Predictive value of preoperative fasting glucose test of diabetic patients regarding surgical outcome in cataract surgery. Arq Bras Oftalmol 2005;68:213-7.  Back to cited text no. 11