Comparative Effects of Atracurium and Rocuronium on Perioperative Blood Glucose in Non-Diabetic Patients Undergoing Appendectomy under General Anesthesia

Abstract

Aims: To compare perioperative capillary blood glucose levels between non-diabetic patients receiving atracurium or rocuronium during general anaesthesia for appendectomy. Study Design: A prospective, randomised, two-group clinical study. Place and Duration of Study: The study was conducted in Najaf, Iraq, from October 2025 to January 2026. Methodology: Thirty non-diabetic patients undergoing appendectomy under general anaesthesia were allocated into two equal groups. Group A received atracurium (0.5 mg/kg; n = 15), while Group B received rocuronium (0.6 mg/kg; n = 15). Capillary blood glucose was measured at three time points: 10 minutes before induction, 10–15 minutes after induction, and 10 minutes after surgery. Data were analysed using GraphPad Prism 9.0. A two-way repeated-measures ANOVA with Geisser–Greenhouse correction was performed, followed by Šídák’s multiple comparisons test. Results were expressed as mean ± standard error of the mean (SEM), with statistical significance set at P < 0.05. Results: Preoperative blood glucose concentrations were comparable between the atracurium and rocuronium groups (92.40 vs 90.27 mg/dL; adjusted P = 0.3109). Intraoperative glucose concentrations were higher in the atracurium group (115.00 vs 105.47 mg/dL; adjusted P < 0.0001). This difference persisted postoperatively (113.33 vs 107.60 mg/dL; adjusted P < 0.0001). Repeated-measures ANOVA demonstrated a significant interaction between treatment group and measurement time (P < 0.0001). Conclusion: Intraoperative and postoperative blood glucose concentrations were significantly higher in the atracurium group than in the rocuronium group. Repeated-measures analysis demonstrated a significant interaction between neuromuscular blocking agent and measurement time. However, the small sample size and potential clinical confounding factors limit causal interpretation. Further controlled studies are required to confirm these findings and determine their clinical significance.