Background: Insulin sensitivity status in different individual varies with BMI, which may necessitate the use of insulin to control glucose level to prevent the development of stress induced insulin resistance during anaesthesia.. Estimation of TNFα and IL6 will reflect closely the insulin resistance state in obesity. Aim is to detect the insulin sensitivity state in obese nondiabetic patients before surgery and anaesthesia.

Objectives: 1.To assess the insulin sensitivity in terms of HOMA and score varies with the BMI status of subjects undergoing surgeries. 2.To assess the levels of IL6 and TNFα, in different BMI status of subjects undergoing

Methods: Nondiabetic,adult patients of body weight above 25kg/mt2 umbilical surgery under general anaesthesia and epidural analgesia were included in Insulin resistance state in different BMI status patients were estimated by HOMA score, serum cortisol, TNFα and IL6 level on the day before surgery. All data were statistically analyzed .

Result: There is a link between obesity and the changes in insulin sensitivity state, Moreover cytokines like Interleukin-6 (IL-6) and TNFα are closely associated with the obesity and insulin sensitivity state.

Discussion: Pre-operative detection of insulin sensitivity state even in nondiabetic patients has paramount importance in planning and selection of anaesthetic technique.to prevent stress induced insulin resistance during surgery. Conclusion: Obese , nondiabetic patients needs meticulous monitoring for prevention of anaesthesia related stress to prevent deterioration of insulin sensitivity state to prevent morbidity and mortality. , posted for infra