Effect of hydroxyethyl starch 6% (130/0.4) which is a colloid solution on blood glucose

Abstract

Hydroxyethyl Starch (HES) 6% (130/0.4) solutions are widely used in clinical practice. This solution has quite long half-life and most of HES particles were held by reticuloendothelial system. It was catabolized by sucrose-isomaltase complex.1 These features of HES solu- tions could influence the blood glucose level. Objective: We aimed to investigate the effect of HES 6% (130/0.4) solution on blood glucose level in patients who received a standard type of anesthesia and surgery. Methods: After Ethics Committee approval and informed consent sixty non-diabetic patients (age 18-75, ASA I-II) scheduled for elective surgery under spinal anesthesia were included in this study. Patients were randomly divided into two groups: Group HES and Group S. Thirty min before spinal anesthesia, fluid infusion was administered to the patients for preloading according to study groups. The patients received 500 ml (HES) 6% (130/0.4) solution in group HES and 1000 ml 0.9% NaCl solution in group S. Capillary blood sugar measurements using a regularly cali- brated standard blood sugar measurement instrument were done before infusion of the fluids (T1), immediately after the infusion (T2), 45 min, 6 h and 12 h after the infusion (T3, T4, T5). Mean blood pressure(MBP), heart rate(HR) and peripheric oxygen saturation (SpO2) were recorded at mentioned meas- urement periods. Spinal anesthesia using 25G Quincke spinal needle and 12.5 mg 0.5% hyperbaric bupivacaine was applied to all prehydrated patients at the left lateral position, through L3-4 or L4-5 intervertebral spaces. The duration of anesthesia and surgery, and complications were recorded. Results: ASA classification, gender, age, duration of surgery and anesthesia were not significant between the groups (p.0.05). Blood sugar levels were higher in group HES at all measurement times(p,0.001, p,0.01, p,0.001, p,0.01, respectively) but in group S it was only higher 6 h after infusion (p,0.05) compared to the values before infusion. At 6th h after infusion, there was a significant differ- ence in blood glucose level between the groups (p,0.001). Discussion and Conclusion: This study showed that blood sugar levels were higher in patients who have infusion of 500 ml (HES) 6% (130/0.4) solution. Infusion of HES 6% (130/0.4) solution altered blood sugar levels of the patients. Six h after HES 6% (130/0.4) infusion, blood sugar was at the highest level. These findings could be carefully taken into consideration in patients whose blood sugar level mea- suremet is important.