Enhanced recovery after spinal surgery protocol versus conventional care in non- insulin diabetic patients: A prospective randomized trial

Figures & data

Figure 1. Consort flow chart.

Figure 2. Comparison of QOR 40 total score between the two studied groups. Values are presented as mean ±SD. *significant differences between groups P < 0.05.

Figure 3. Comparison of random blood sugar (mg/dL) between the two studied groups. Values are presented as mean ±SD. *significant differences between groups P < 0.05.

Figure 4. Comparison of visual analogue score (VAS) between the two studied groups. Values are presented as mean ±SD. *significant differences between groups P < 0.05.

Table 1. Demographic characteristics.

	Group E	Group C	p- value
Number (n)	36	36
Age (year)	53.36 ± 8.12	53.03 ± 7.96	0.349
Sex M/F	17/19	19/17	0.321
BMI (kg/m2)	29.36±3.09	28.24±2.88	0.066
ASA physical status I/II	35/1	35/1	1.000
Number of levels 2/3	20/16	21/15	0.818
Duration of surgery (min)	143.33 ± 24.96	145.83 ± 23.95	0.611
Comorbidities
Hypertension	11 (30.6)	9 (25.0)	0.321
Bronchial asthma	1 (2.8)	2 (5.6)	0.511
Hypothyroidism	4 (11.1)	1 (2.8)	0.177
IHD	4 (11.1)	1 (2.8)	0.177
NIDDM	36 (100)	36 (100)	1.000

Values are presented as mean ± SD or number (percentage), BMI = body mass index, IHD = ischemic heart disease. NIDDM= Non-insulin dependent diabetes mellitus.; ASA: American Society of Anesthesiologists (physical status).

Table 2. Perioperative data.

	Group E	Group C	p- value
Intraoperative fentanyl consumption (ug)	150.56 ± 19.12	236.11 ± 35.07	0.001*
Time to first analgesic (min)	362.78±115.65	33.19 ± 9.27	0.001*
Postoperative nalbuphine consumption (mg)	9.61 ± 2.56	19.69 ± 5.10	0.001*
Time to modified Aldrete score ≥ 9	17.39 ± 3.16	21.97 ± 4.96	0.001*
Intraoperative insulin requirements (units)	3.33 ± 1.03	3.60 ± 1.14	0.347
Number of patients required intraoperative insulin	6 (16.7)	5 (13.9)	0.328
Total blood loss	859.17 ± 350.18	913.89 ± 380.90	0.449
Number of patients required rescue antiemetic	5 (13.9)	11 (30.6)	0.013*
Postoperative nausea &vomiting n (%)	5 (13.9)	11 (30.6)	0.016*
Time to early ambulation (hrs)	10.03 ± 1.59	12.50 ± 2.26	0.006*
Hospital stay(days)	3.83 ± 0.38	3.89 ± 0.32	0.251

Values are presented as mean±SD or number (percentage). *Significant differences between groups P < 0.05.

Table 3. Comparison of C-reactive protein (mg-dl-1) and interleukin-6 (pg.Ml-1) between the two studied groups.

Biomarkers	Group E	Group C	p- value	95.0% C.I
C- Reactive protein
Preoperative	1.78 ±0.66	1.93±0.68	0.174	0.13–2.60
Immediately after recovery	4.87±5.16	4.73±4.83	0.305	0.36–1.85
POD2	43.57±13.07	88.95±31.49	0.001*	0.11–0.82
Interleukin 6 (pg.ml−1)
Preoperative	1.05±0.11	1.08±0.17	0.097	0.12–2.15
Immediately after recovery	1.15±0.12	1.15±0.18	0.062	0.25–1.98
POD2	1.06±0.13	1.21±0.19	0.017*	0.11–0.91

Values are presented as mean ±SD. *Significant differences between groups P < 0.05.