IJCM> Vol.4 No.9, September 2013

Author(s)

Ricardo Mota Pereira, Fátima Gonçalves, João Costa, Filomena Couto, Carolina Sá, Isabel Neves, Lucindo Ormonde

Department of Anaesthesiology, Santa Maria University Hospital, Lisbon, Portugal.
Department of Anaesthesiology, Santa Maria University Hospital, Lisbon, Portugal Instituto de Medicina Molecular (IMM), Faculty of Medicine, University of Lisbon, Lisbon, Portugal;.
Department of Anaesthesiology, Santa Maria University Hospital, Lisbon, Portugal;.
Department of Gynaecology, Santa Maria University Hospital, Lisbon, Portugal..
Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal; Evidence-Based Medicine Centre, Faculty of Medicine, University of Lisbon, Lisbon, Portugal; Instituto de Medicina Molecular (IMM), Faculty of Medicine, University of Lisbon, Lisbon, Portugal;.

Background: Hyperglycaemia is conversely a risk factor for perioperative complications. We are currently using a generic 3.3 g glucose containing formula of intravenous 1000 mg paracetamol for perioperative analgesia. Our main goal was to compare the trends of glycaemic values after administration of a generic 3.3 g glucose containing formula with a non-glucose containing branded formula of intravenous 1000 mg paracetamol. Methods: A exploratory proof-of-concept randomized clinical trial was conducted with 150 patients scheduled for elective gynaecologic. Patients were randomly assigned into three groups: control group (saline); active-control group: intraoperative administration of a branded non-glucose containing 1000 mg paracetamol formula; experimental group: intraoperative administration of a generic 3.3 g glucose containing 1000 mg paracetamol formula. The primary outcome was mean change from baseline in glaucoma. In case significant differences were found, the following secondary outcomes were explored: the proportion of patients with high glycaemia values (>150 mg/dL) and the proportion of patients with negative glycaemic variation. Results: Mean glycaemia change was higher after generic 3.3 g glucose containing paracetamol formula both in comparison to placebo (16.3 mg/dL [95% CI: 6.1 to 26.6]) and active-control (19.1 mg/dL [8.2 to 30.0] groups. Similar results were found in the intention-to-treat analysis. In only the experimental group, patients had high glycaemic values (11.3%). Conclusions: This study showed that in non-diabetic, under non-cardiac surgery, administration of a generic glucose-containing formula of intravenous 1000 mg paracetamol was associated with poorer glycaemic control. These results raise the question of a possible increased risk among these patients. Further studies using diabetic patients are recommended.

Paracetamol; Hyperglycaemia; Gyneacologic Surgical Procedures; Randomized Controlled Trial

R. Pereira, F. Gonçalves, J. Costa, F. Couto, C. Sá, I. Neves and L. Ormonde, "Intraoperative Glycaemia Following Paracetamol with and without Glucose: A Randomized-Controlled Trial," International Journal of Clinical Medicine, Vol. 4 No. 9, 2013, pp. 409-416. doi: 10.4236/ijcm.2013.49074.