• Tarik Wasfie, Anthony Tabatabai, Ravi Hedni, Linda Hollern, Kimberly Barber, and Brian Shapiro.
• Department of Surgery, Genesys Regional Medical Center, Grand Blanc, MI, USA.
• Am. J. Surg. 2018 Mar 1; 215 (3): 488-490.

BackgroundDexamethasone adds a unique challenge to glycemic control, and it may complicate patient care if there is an association between intra-operative dexamethasone and blood glucose levels.MethodsWe analyzed 396 diabetic patients who underwent general anesthesia for various surgical procedures and were hospitalized post-operatively for at least 24 h between January 2015 and June 2016. Patients were classified into two groups-those who received dexamethasone intra-operatively and those who did not. The groups were analyzed for blood glucose changes during and following their procedure.ResultsA total of 396 diabetic patients (152 (38.8%) dexamethasone group; 244 (62.2%) control) were included. The dexamethasone group had significantly lower preoperative blood glucose (135.5 mmol/L) compared to the control group (144.4 mmol/L) (p = 0.04) and significantly lower proportion of patients who had received insulin during surgery (14.9%) compared to the control group (23.4%) (p = 0.04). Overall, glucose levels declined from pre-op to post-op day 1 by 9.6 (62.9) (p = 0.007).ConclusionDiabetic patients receiving dexamethasone for control of post-operative nausea during surgery are at greater risk for increasing blood glucose levels and difficult glycemic control during and after surgery compared to patients receiving other medications to control post-operative nausea.Copyright © 2017 Elsevier Inc. All rights reserved.

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