A small perioperative study found no detectable glucose difference between propofol–fentanyl and midazolam–fentanyl. Both groups received an opioid, which limits attribution to either sedative alone.
Khalighinejad and colleagues enrolled diabetic cataract-surgery candidates and analyzed 70 participants, 35 in each group. Glucose was checked before surgery, during the operation, and at its completion.
Mean glucose was approximately 149 mg/dL in both groups, and the repeated-measures comparison was not significant. The findings concerned light sedation during a specific procedure and the selected accompanying medications.
The authors used a glucometer rather than laboratory glucose measurement and did not standardize fasting duration fully. Both factors can affect measured glucose and its baseline variability.
The lack of a significant difference does not establish equal effects in prolonged operations, unstable diabetes, or different sedation depths. It also does not isolate midazolam from fentanyl or show that either regimen prevents hypoglycemia in all circumstances.
Separate glucose observations from signs of sedation or respiratory compromise. A similar glucose pattern is not evidence of equivalent memory, consciousness, or overall safety. The paper can inform a discussion of one metabolic endpoint while other explanations for altered postoperative behavior remain to be examined.
Original analysis of the supplied paper: Changes in blood glucose level during and after light sedations using propofol fentanyl and midazola. Paper identifier: PMC4638056.