Patients of traumatic brain injury (TBI) may have hyperglycemia and when they undergo craniotomy, hyperglycemia may be exacerbated and worsen outcome. However, epidemiology of perioperative hyperglycemia in these patients is unknown. The epidemiological study has been undertaken to address the correlation between intraoperative blood glucose variability in nondiabetic adult TBI patients undergoing craniotomy with the severity and type of brain trauma and patients’ demographic variables.
A total of 200 adult nondiabetic patients undergoing emergency craniotomy for TBI were recruited in this prospective single-group observational study. Baseline capillary blood glucose (CBG) measurement was performed immediately before induction of anesthesia and then at half hourly interval until the end of surgery and 1 hour after the end of surgery.
Incidence of at least 1 episode of intraoperative hyperglycemia (CBG≥180 mg/dL) is 20% in patients with TBI during emergency craniotomy. Independent predictors of intraoperative hyperglycemia are severe head injury (Glasgow-Coma score [GCS] <9) and acute subdural hemorrhage. Baseline CBG also correlates with subsequent intraoperative and postoperative CBG.
Hyperglycemia is common during emergency craniotomy in TBI patients. We recommend routine monitoring of blood glucose in the intraoperative and postoperative period at least in severe head injury patients.
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*Department of Anaesthesiology & Intensive Care
§Department of Anaesthesiology, JPNATC, All India Institute of Medical Sciences
†Department of Anaesthesiology, Chacha Nehru Bal Chikitsalaya, New Delhi
‡Department of Critical Care Medicine, Lilavati Hospital & Research Center, Mumbai
∥Department of Anaesthesiology, Institute of Post Graduate Medical Education & Research, Kolkata, India
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The authors have no funding or conflicts of interest to disclose.
Reprints: Souvik Maitra, MD, F 35/2 Third Floor, Gautam Nagar, New Delhi 110049 (e-mail: firstname.lastname@example.org).
Received October 28, 2013
Accepted February 11, 2014