A Comparative Study between the Effects of Spinal Anesthesia and General Anesthesia on Perioperative Hyperglycemia and Postoperative Wound Infection in Patients Undergoing Hip Arthroplasty

Abstract

According to statistical findings, it has been determined that a greater majority of surgical patients, whether diabetic or not, have abnormalities in glucose control during their hospitalization as part of the stress response that occurs in many patients during the perioperative period.

This hyperglycemia - commonly referred to as ‘stress hyperglycemia’ - can negatively affect patient outcomes. This is because it impairs the immune system, therefore causing an increase in postoperative complications, particularly infections, eventually leading to a lengthened hospital stay and unexpected health costs.

Anesthetic techniques can be used to minimize the stress response and its consequences, including hyperglycemia, in both diabetic and nondiabetic patients. These techniques are mainly neural blockade by regional or neuraxial anesthesia, intravenous administration of high-doses of strong opioid analgesics as in general anesthesia, and finally, the administration of medications such as anabolic hormones (e.g. insulin) that can cause a change in the patient’s hormonal status.