Effect of spinal anesthesia versus general anesthesia on blood glucose concentration in patients undergoing elective cesarean sections.

Abstract

Objective: To compare mean blood sugar levels in patients undergoing elective cesarean sections through spinal versus general anaesthesia. Study Design: Prospective Cohort Study. Setting: Department of Anaesthesiology, Allama Iqbal Teaching Hospital DG Khan. Period: 1^st March 2024 to 31^st August 2024. Methods: Non-diabetic pregnant women aged 20 – 45 years with ASA-I status undergoing elective cesarean section were enrolled. Women with diabetes, eclampsia / preeclampsia, cardiomyopathy or allergy to anesthetic agents were excluded. Participants were categorized as exposed if opted for spinal anesthesia and unexposed if opted for general anesthesia. Blood glucose levels were measured preoperatively and 30 minutes of surgery using a standardized glucometer. Descriptive statistics are run using SPSS version 23. Numerical and categorical comparisons across the groups are made through t-test and chi-square test respectively at 5% significance level. Results: A total of 248 patients (124 per group) were included. Baseline characteristics including BMI, fasting duration, surgery duration and fluid type were comparable. Mean preoperative blood glucose was higher in spinal than general anesthesia group (83.9 ± 8.3 vs. 81.2 ± 8.6 mg/dl; p = 0.011). Post-operative glucose levels were significantly higher in spinal (126.4 ± 15 vs. 56.7 ± 9.8 mg/dl; p-value < 0.001). This difference remains significant across stratified groups. Conclusion: Spinal anesthesia was associated with significantly higher postoperative blood glucose levels compared to general anesthesia in non-diabetic women undergoing cesarean section. Monitoring perioperative glucose in spinal anesthesia may warrant further attention.