Midazolam infusion might preserve glucose and lipid homeostasis during surgery under general anesthesia: Placebo-controlled comparative study

Abstract

Abstract Background Anesthesia and surgery each per se is a stressful condition that may affect the postoperative patients’ outcomes. Hyperglycemia is the commonest result of surgical stress response and must be adjusted not only in diabetics to improve outcomes. Aims To determine changes in blood glucose (BG) and serum lipids and cortisol levels after intraoperative midazolam infusion for patients undergoing surgery under general anesthesia. Patients and Methods: 160 ASA I or II non-diabetic patients were randomly divided as Control patients received placebo infusion and Study patients received midazolam infusion (0.35 µg/kg/min). All patients gave blood samples before (S1) and 30-min after the start (S2) and at the end of infusion (S3) for estimation of BG and serum lipids and cortisol levels. The study outcome was the change in the levels of estimated parameters in relation to their preoperative levels. Results BG levels estimated in S2 and S3 samples were significantly higher than S1 levels of all patients but were significantly lower in samples of study than control patients. Serum levels of triglycerides and very low-density lipoproteins (VLDL), and cortisol in S3 study samples were significantly lower than in S3 control samples. Conclusion Intraoperative midazolam infusion could minimize surgical stress response with a significant decrease in serum cortisol, triglycerides, and VLDL and significantly lower BG concentrations in comparison to placebo infusion.