Effect of induction of general anaesthesia with etomidate, propofol and thiopentone on serum cortisol and blood sugars in diabetic patients undergoing open gastrointestinal surgery – A randomized controlled study.

This prospective randomised study will include 40 patients  posted for elective open  gastrointestinal surgeries under combined general epidural anaesthesia of both gender aged 18 to 70 years with diabetes   after obtaining Institute Ethics approval ,CTRI registration and paients written informed consent.Exclusion criteria will include  Hepato- biliary and pancreatic surgeries , patients receiving steroids, beta blockers, renal, hepatic disease, prgnant, lactating women.  Premedication will be with tablet raniditidine and alprozolam and fasted for 6 hours before surgery.  Intraop ASA Monitors will be connected. Epidural catheter  will be secured at T8-10 intervertebral disc space . Premedication with fentanyl followed  by induction with etomidate/thiopentone/propofol as pwer randomisation (. Later oral intubation with rocuronium muscle relaxant. Arterial cannula in radial artery will be secured  Intraop maintance will be  air:O2 (1:1) ,atracurium, fentanyl, sevoflurane . After surgery completion, parient will be extubated and shifted to postop area.  Parameters to be measured will be Serum cortisol  baseline, 4 and 24 hours after induction, blood sugars  at baseline, postinduction 4, 12 and 24 hours