Perioperative Blood Glucose Status of Diabetic Patients Receiving Balanced General Anaesthesia and Total Intravenous Anaesthesia During Laparoscopic Cholecystectomy: A Comparative Study

Open Access

Abstract

Background: Anaesthesia and laparoscopic surgery can worsen glycaemic control in diabetic patients, raising the risk of ketoacidosis, circulatory compromise, infection and death. General and total intravenous anaesthesia may influence glucose metabolism differently through varying effects on stress response and insulin sensitivity. Objective: This study aimed to evaluate and compare perioperative blood glucose status in type 2 diabetic patients receiving balanced general anaesthesia and total intravenous anaesthesia during laparoscopic cholecystectomy. Methods & Materials: This quasi-experimental study was conducted over one year at Bangladesh Medical University. Sixty diabetic patients undergoing laparoscopic cholecystectomy were allocated alternately into two equal groups: Group T received total intravenous anaesthesia with propofol and remifentanil and Group G received balanced general anaesthesia with isoflurane and remifentanil. Blood glucose was measured before induction, after intubation, during pneumoperitoneum and at end of surgery. Data were analyzed in SPSS 25 using independent t-test, Mann-Whitney U test, or chi-square test, with p less than 0.05 considered significant. Results: Baseline characteristics were comparable between groups except gender (p=0.045). Blood glucose rose progressively in both groups but did not differ significantly at any time point: before induction (6.05 versus 6.15 mmol/L, p=0.853), after intubation (6.10 versus 6.05 mmol/L, p=0.428), during pneumoperitoneum (6.80 versus 6.50 mmol/L, p=0.239) and end of surgery (8.10 versus 8.00 mmol/L, p=0.561). No adverse anaesthetic effects were observed. Conclusion: Both techniques maintained comparable perioperative glycaemic control in type 2 diabetic patients undergoing laparoscopic cholecystectomy, supporting either as a safe anaesthetic option in this population.