Effects of Steroid Administration on the Blood Glucose Level during Spine Surgery in Patients with Metabolic Syndrome

Kim, Hyun Jung; Kim, Dong Won; Kim, Bum Suk; Kim, Kyu Nam; Shim, Jae Chul; Suh, Jung Kook; Yi, Hyeong Joong; Ryu, Keon Hee

Clinical Research

Neuroanesthesia

Anesthesia and Pain Medicine 2008;3(1):44-48.
Published online January 30, 2008.

Effects of Steroid Administration on the Blood Glucose Level during Spine Surgery in Patients with Metabolic Syndrome

Hyun Jung Kim, Dong Won Kim, Bum Suk Kim, Kyu Nam Kim, Jae Chul Shim, Jung Kook Suh, Hyeong Joong Yi, Keon Hee Ryu

¹Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea. dongwkim@hanyang.ac.kr
²Department of Neurosurgery, Hanyang University College of Medicine, Seoul, Korea.
³Department of Anesthesiology and Pain Medicine, National Medical Center, Seoul, Korea.
⁴Department of Anesthesiology and Pain Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.

Abstract

BACKGROUND
The risk of steroid-induced hyperglycemia is debated, and methylprednisolone is still used during spinal surgery. We have compared the blood glucose level in patients with metabolic syndrome treated with or without methylprednisolone. METHODS: This study was conducted in 68 adult patients who underwent elective spine surgery. Patients were classified into the following groups: methylprednisolone group (n = 39, group M), placebo group (n = 29, group P), group M patients with metabolic syndrome (n = 17, group MM), and group P patients without metabolic syndrome (n = 21, group NMP). Before and after injection of either 125 mg methylprednisolone or a placebo, we consecutively checked the blood glucose level every 30 minutes up to 4 hours. RESULTS: The blood glucose level was significantly increased in group M patients as compared to group P patients. The blood glucose level was more significantly increased in group MM as compared to group NMP patients. The increased blood glucose levels over 4 hours were 50 mg/dl in group MM and 35 mg/dl in group NMP patients. CONCLUSIONS: We recommend that close monitoring of the blood glucose level up to several hours after injection of a steroid should be seriously considered during spine surgery, particularly in patients with metabolic syndrome.

Key Words: blood glucose, methylprednisolone, spine surgery