dc.contributor.author | Bachubhai, Sonigra J | |
dc.date.accessioned | 2014-01-21T08:37:38Z | |
dc.date.available | 2014-01-21T08:37:38Z | |
dc.date.issued | 1989 | |
dc.identifier.citation | A Dissertation Submitted In Part Fulfilment For The Degree Of Master Of Medicine (Anaesthesia) Of The University Of Nairobi | en_US |
dc.identifier.uri | http://hdl.handle.net/11295/64060 | |
dc.description.abstract | A prospective study was carried out at Kenyatta National Hospital to
determine the blood sugar levels in two groups of children - one starved and
coming for surgery and the other group not starved. Both groups consisted
of in-patient children ranging from half to ten years age. The aim of the
study was to deter mine whether there was a statistical significance
between the two groups and to determine the correlation between the length
of fast and the blood glucose levels.
The first group (starved children) consisted of one hundred and ten
inpatients of which males were seventy five i.e. 68.3% and females
were thirty five i.e. 31.7%. The average age of the children in this group was
5.9 ~2.9 years and ranged from six months to ten years. These patients
were all starved from the last hospital meal, at around 6 p.m. in the evening.
except for a few very small children who were fed at around midnight. The
mean length of fast in this group was 16.7 =.....3.0 hours and ranged from 9.7 to
22.8 hours. Premedication was the same for all patients in this group being
Atropine O.Olmg/kg body weight and pethidine 1.0 - 1.5 mg /kg body weight.
The blood samples were taken immediately after an inhalation induction
with nitrous oxide (67%) oxygen (33%) and halothane (0-3%) before
intubation or any surgical stimulus. The mean blood glucose level in this
group was 3.3:!:. 0.35 mrnol/I and ranged from 2.4 - 4.4 mrnol/L
The second group (non starved) was the control group and consisted of
inpatients who were for surgery, but not on the day of sampling and had
hence had their morning breakfast - at approximately 6 a.m This group
consisted of eighty five patients of which males were 50 (58.8~,) and fe males
were 3 5( 41.2 %) The average age was 7.6 years and ranged from 2.3 to 10
years. The mean length of fast was 1.8 ~ 1.1 hours and ranged from 0.3 to
3.8 hours. The samples were taken from willing patients and the average
blood sugar level was 5.2 ~ 0.5 mmolll and ranged from 3.6 to 6.3 mmolll.
It was found that none of the patients in either group was hypoglycemic.
although some of the children in the study group had very low blood sugar
levels.
One patient was discovered to be an undiagnosed diabetic with a fasting
. blood sugar of 20.8 mmolll which was reconfirmed. This patient was not
included in the study and the information conveyed to the relevant ward.
The study showed that 38.2% of the patients in the study group had a value
corresponding to the mean sugar level vaule, whereas in the control group. it
was 1().O% of the patients with the mean value.
The study also showed that as whereas 37 (33.7% of the patients in the first
group had blood sugar levels of less than 3.3 mmolll no patients in the
second group had a blood sugar level of less than 3.6 mmol/I.
Out of the 37 children in the first group, 28 (25.Y~) were males and the
remaining 9 (8.2%) females. It was also Found that .3 (2.7% I of the patients
had a blood sugar level of less than 2.8 mmolll out of which 2 ( 18 % I were mall
and 1 (0.99%) was a female.
The difference between the mean glucose levels of both groups was found to
be statistically significant (P< 0.01 ) and that there was no correlation
between the length of the fast and the blood sugar level.
Hypoglycemia in this study, as well as in others was definded as a blood
sugar level of less than 2.2 mmolll (40 mg/ dl),
It is recommended that patients should not be given a feed for 6 hours preoperatively
and clear liquids for 4 hours pre-operatively and that intravenous
fluids should be continued post-operatively to correct fluid deficits
till the patient is fully awake and feeding orally. | |
dc.language.iso | en | en_US |
dc.publisher | University of Nairobi | en_US |
dc.title | Blood Sugar Levels In Starved In-patient Children Coming For Elective Surgery As Compared To Non-Starved In-patients At The Kenyatta National Hospital. | en_US |
dc.type | Thesis | en_US |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |