Dependence of perioperative glycemia on analgesia technique for hip joint arthroplasty

DEPENDENCE OF PERIOPERATIVE GLYCEMIA ON ANALGESIA TECHNIQUE FOR HIP JOINT ARTHROPLASTY KOLOMACHENKO V.I. Kharkiv Medical Academy for Postgraduate Education Aim. The hip joint arthroplasty has high risk of perioperative hyperglycemia due to stress response and insulin resistance. The analgesia technics differ in terms of provided analgesia and anti-stress protection. The aim of our study was analyzing of blood glucose, insulin and HOMA-index dynamics during perioperative period in patients who underwent total hip arthroplasty according to the anaesthesia and analgesia techniques. Material and Methods. The study included 150 patients undergoing primary total hip joint replacement. We analyzed the dynamics of blood glucose, insulin and HOMA-index in relation to four variants of intraoperative anaesthesia and three variants of postoperative analgesia techniques, pathology type and patients' gender. Tests were taken before and during surgery, as well as at the 1st postoperative day. Results and Discussion. The preoperative glycemia level before surgery among all groups did not differ significantly (ð>0,1). In the operating room, after the general anaesthesia administration but before the start of the surgery, the patients demonstrated significant increase in glycemia up to 6,3 mmol/ L, and it was significantly higher compared to groups of patients with nerve blocks, paravertebral+caudal anaesthesia and spinal anaesthesia (ð<0,01). At the traumatic stage of surgery, glycemia was significantly higher in groups of general anaesthesia and nerve blocks, 6,98 ànd 6,43 mmol/L, respectively. At the 1st postoperative day, the highest level of glycemia was detected in patients receiving systemic opioid analgesia, whose level of glycemia was 0,87 mmol/L higher than the initial value before surgery; in the