Does the Administration of Preoperative Midazolam Assist in Maintaining Blood Glucose Norms in the Non - Diabetic Patient during the Perioperative Period?

Introduction: Surgery induces stress response, which can cause elevated blood glucose level. In addition to tissue injury and inflammation, anxiety can contribute to the stress response. We measured the effect of preoperative midazolam administration on perioperative glucose levels to determine if midazolam administration will have beneficial effects on perioperative glucose levels. Materials and Methods: Sixty non-diabetic patients between the ages of 18 and 80 were randomized into two groups. One group received preoperative midazolam and the other group received a placebo. The anesthetic regimen was controlled in both groups. Blood glucose levels were measures preoperatively and at predetermined intervals during surgery and in the post anesthesia care unit (PACU). The increases in the blood glucose levels from the preoperative value as well as percentage of patients with maximum glucose value less than 140mg/dl were compared between the groups. Results: The patient characteristics and surgical as well as anesthetic factors were similar in both groups. There were no statistically significant differences in the percent increase in blood glucose levels between the groups. The median (interquartile range) percent increase from preoperative to maximum glucose in the midazolam group was 14.93(29.81) and in the placebo group was 24.98(27.11) with a P value of 0.56. The percentage of patients with blood glucose levels ≤ 140 was 86.67 in midazolam group vs 100 in the placebo group (P value .12). Conclusion: Preoperative administration of midazolam did not cause attenuation of the hyperglycemic response compared to the placebo group.