الفهرس 
Perioperative HyperglycemiaOnly 14 pages are availabe for public view
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Abstract
A Comparative Study between the Effects of Spinal Anesthesia and General Anesthesia on Perioperative Hyperglycemia and Postoperative Wound Infection in Patients Undergoing Hip Arthroplasty
Authors: Effat, Nahed; El-Hennawy, Ahmed; El-Gendy, Mohammed; Hassan, Raham; Elsamragy, Shahenaz.
According to statistical findings, it has been determined that a greater majority of surgical patients, whether diabetic or not, have abnormalities in glucose control during their hospitalization as part of the stress response that occurs in many patients during the perioperative period. This hyperglycemia - commonly referred to as ‘stress hyperglycemia’ - can negatively affect patient outcomes. This is because it impairs the immune system, therefore causing an increase in postoperative complications, particularly infections, eventually leading to a lengthened hospital stay and unexpected health costs. Anesthetic techniques can be used to minimize the stress response and its consequences, including hyperglycemia, in both diabetic and nondiabetic patients. These techniques are mainly neural blockade by regional or neuraxial anesthesia, intravenous administration of high-doses of strong opioid analgesics as in general anesthesia, and finally, the administration of medications such as anabolic hormones (e.g. insulin) that can cause a change in the patient’s hormonal status.
This purpose of our study was to clinically evaluate and statistically compare the effects of two anesthetic techniques; general and spinal anesthesia, with regards to perioperative hyperglycemic responses and the subsequent incidence of wound infection in non-diabetic patients undergoing elective hip arthroplasty.
The study was carried out on sixty patients, who were randomly divided into two equal groups, where one group received spinal anesthesia and the other group received general anesthesia. Their data regarding perioperative blood sugar measurements and postoperative indications of surgical site infections (SSIs) were then collected and compared. We concluded through our study that the anesthetic technique used has a definite effect on the surgical stress response, which in turn affects the incidence of postoperative complications, such as SSIs.
Our results indicated the superiority of spinal anesthesia with regards to blunting of the stress response compared to general anesthesia and in turn this led to a much lower incidence of postoperative SSIs in the former compared to the latter.