• Ranjana Khetarpal, Veena Chatrath, Jagjit Kaur, Anju Bala, and Harjeet Singh.
• Department of Anaesthesia and Critical Care, Government Medical College, Amritsar, Punjab, India.
• Anesth Essays Res. 2016 Sep 1; 10 (3): 425-431.

BackgroundIntravenous (IV) fluids are an integral part of perioperative management. Intraoperative hyperglycemia is associated with poor clinical outcomes in patients undergoing major surgeries even in nondiabetics.AimThis study was conducted to observe the effect of different maintenance fluid regimens on intraoperative blood glucose levels in nondiabetic patients undergoing major surgeries under general anesthesia.Settings And DesignRandomized double-blind study.Materials And MethodsOne hundred nondiabetic patients of either sex were divided randomly into two Groups I and II of 50 each undergoing elective major surgeries of more than 90 min duration under general anesthesia. Both groups were given calculated dosage of IV fluids accordingly 4-2-1 formula while Group I was given Ringer lactate (RL) and Group II was given 0.45% dextrose normal saline and potassium chloride 20 mmol/L. Changes in vital parameters, % oxygen saturation, and urine output were monitored at regular intervals. Capillary blood glucose (CBG) was measured half-hourly until end of surgery. If CBG level was more than 150 mg%, then calculated dose of human insulin (CBG/100) was given as IV bolus dose.Statistical AnalysisStatistical analysis was done using SPSS 22.0 software (IBM Corporation, Armonk, New York, USA), paired t-test and Chi-square test.ResultsA significant increase of CBG level and was observed during intraoperative and immediate postoperative period (P < 0.001) in Group II.ConclusionRL solution is probably the alternative choice of IV fluid for perioperative maintenance and can be used as replacement fluid in nondiabetic patients undergoing major surgeries.

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