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.
Objectives: 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 & 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 end of infusion (S3) for
estimation of BG and serum lipids and cortisol levels. The study outcome was the change of 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.