Anaesthetic management of patients with diabetes mellitus

McAnulty, Greg; Robertshaw, Heidi; Hall, George

doi:10.1093/bja/85.1.80

Cited by 115 publications

(67 citation statements)

References 113 publications

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“…3 Disease states associated with diabetes render the diabetic at an increased risk of perioperative complications. 4 Diabetics requiring insulin are at an increased risk [odds ratio (OR) 3.0, 95% confidence interval (CI) 1.3-7.0] of perioperative cardiac complications. 5 Critical respiratory events are more common [relative risk (RR) 2.08, 95% CI 1.42-3.04] among diabetics.…”

Section: Conclusion : L'anesthésie Ambulatoire Peut êTre Réalisée Chementioning

confidence: 99%

Patient selection in ambulatory anesthesia — An evidence-based review: part II

et al. 2004

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P Pu ur rp po os se e: : This is the second of two reviews evaluating the management of patients with selected medical conditions undergoing ambulatory anesthesia and surgery. Conditions highlighted in this review include: diabetes mellitus; morbid obesity; the ex-premature infant; the child with an upper respiratory infection; malignant hyperthermia; and the use of monoamine oxidase inhibitors.S So ou ur rc ce e: : Medline search strategies and the framework for the evaluation of clinical evidence are presented in Part I. P Pr ri in nc ci ip pa al l f fi in nd di in ng gs s: : Diabetes mellitus has not been linked with adverse events following ambulatory surgery. The morbidly obese patient is at an increased risk for minor respiratory complications in the perioperative period but these events do not increase unanticipated admissions. The ex-premature infant may be considered for ambulatory surgery if post-conceptual age is > 60 weeks and hematocrit is > 30%. The child with a recent upper respiratory tract infection is at an increased risk for perioperative respiratory complications, particularly if endotracheal intubation is required. Patients with malignant hyperthermia may undergo outpatient surgery but require four hours of postoperative temperature monitoring. Sporadic cases of drug interactions have been reported when meperidine and indirectacting catecholamines are administered in the presence of monamine oxidase inhibitors. Ambulatory anesthesia and surgery is safe if these combinations of drugs are avoided.C Co on nc cl lu us si io on n: : Ambulatory anesthesia can be performed in, and is being offered to, a variety of patients with significant coexistent disease. In many cases there is little evidence documenting the outcomes expected in such patients. Prospective observational and interventional trials are required to better define perioperative management. Objectif : C'est la seconde revue qui évalue la prise en charge de patients, dont les pathologies médicales ont été ciblées, qui doivent subir une anesthésie en chirurgie ambulatoire. Les situations choisies comprennent : le diabète, l'obésité morbide, l'enfant né prématurément, l'enfant atteint d'infection des voies respiratoires supérieures, l'hyperthermie maligne et l'usage d'inhibiteurs de la monoamine-oxydase. Source : Les stratégies de recherche dans Medline et le cadre de l'é-valuation de la preuve clinique sont présentés dans la partie I. Constatations principales : Le diabète n'a pas été relié à des événements indésirables à la suite d'une opération ambulatoire. Le patient très obèse est plus à risque de complications respiratoires péri-opératoires mineures, ce qui n'augmente pas les admissions hospitalières imprévues. L'enfant prématuré est admis en chirurgie ambulatoire si l'âge post-conception est > 60 semaines et si l'hématocrite est > 30 %. L'enfant qui a une infection récente des voies respiratoires supérieures

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Section: Conclusion : L'anesthésie Ambulatoire Peut êTre Réalisée Chementioning

confidence: 99%

Patient selection in ambulatory anesthesia — An evidence-based review: part II

et al. 2004

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“…In the recent two or three decades, the prevalence of diabetes mellitus (DM) has rapidly increased throughout the world, the estimation being that it will increase by 200 % in the next several decades (1)(2)(3)(4)(5). As a result, physicians will be encountered with an increasing population of diabetic patients undergoing anesthesia and surgery with serious complications, such as hypertension, ischemic heart disease in association with signifi cant increases in length of stay and mortality rates in hospital, as well as nephropathy, and autonomic neuropathy (1)(2)(3).…”

mentioning

confidence: 99%

“…As a result, physicians will be encountered with an increasing population of diabetic patients undergoing anesthesia and surgery with serious complications, such as hypertension, ischemic heart disease in association with signifi cant increases in length of stay and mortality rates in hospital, as well as nephropathy, and autonomic neuropathy (1)(2)(3).…”

mentioning

confidence: 99%

Investigation of the effects of propofol and vitamin C administration on erythrocyte deformability in rats with streptozotocin-induced

Fm¹,

Öztürk²,

Alkan³

et al. 2014

BLL

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Abstract:Purpose: In the current study we aim to investigate the effects of vitamin C and profol on red blood cell deformability in diabetic rats Materials and methods: Twenty-eight Wistar Albino rats were included in the study after streptozocin (60 mg/ kg) treatment for 4 weeks of observation for diabetes presence. Twenty-eight rats were allocated to 4 groups. In group DP (n = 7) 150 mg.kg -1 of propofol was injected intraperitoneally. In group DP-vit C (n = 7) rats 100 mg/kg of vitamin C (Ascorbic acid, Redoxon ® 1000 mg/5 mL -Roche) were applied one hour before administrating 150 mg.kg -1 of propofol, while rats in control group (n = 7), and diabetic control group (n = 7) received intraperitoneally physiological saline. Deformability measurements were achieved by using erythrocyte suspensions with hematocrit level of 5 % in PBS buffer. Results: Erythrocyte deformability was signifi cantly higher in diabetic control group than in control and vitamin C plus propofol groups (p = 0.00, p = 0.025, respectively). Erythrocyte deformability indexes were found similar in control group and vitamin C plus propofol group (p = 0.949). Relative resistance was increased in diabetic rat model. Conclusions: Erythrocyte deformability was damaged in rats with diabetes. This injury might lead to further problems in microcirculation. Application of propofol did not alter red cell deformability in diabetic rats. Vitamin C supplementation seems to reverse those negative effects and variations in erythrocyte deformability (Fig. 2

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“…In the recent two or three decades, the prevalence of diabetes mellitus (DM) has rapidly increased throughout the world, with the estimation that it will increase by 200 % in the next several decades (1)(2)(3)(4). As a result, physicians will be encountered with an increasing population of diabetic patients undergoing anesthesia and surgery and also the patients may have serious complications, such as hypertension, ischemic heart disease in association with signifi cant increases in length of stay and mortality rates in hospital, as well as nephropathy, and autonomic neuropathy (1)(2)(3).…”

mentioning

confidence: 99%

“…As a result, physicians will be encountered with an increasing population of diabetic patients undergoing anesthesia and surgery and also the patients may have serious complications, such as hypertension, ischemic heart disease in association with signifi cant increases in length of stay and mortality rates in hospital, as well as nephropathy, and autonomic neuropathy (1)(2)(3). Moreover, the diabetics have as much as two to three fold higher frequency of cardiovascular disorders and three times higher mortality rates in comparison to the healthy population (4).…”

mentioning

confidence: 99%

Effect of dexmedetomidine on erythrocyte deformability during ischemia-reperfusion injury of liver in diabetic rats

Arslan¹,

Çomu²,

Işık³

et al. 2012

BLL

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Abstract:Aim: The aim of this study is to evaluate the effect of dexmedetomidine on erythrocyte deformability during IR injury of liver in diabetic rats. Methods: Twenty-eight Wistar Albino rats were included in the study after a 4 week streptozocin (65 mg/kg) treatment to observe the existence of diabetes. The animals were randomly assigned to one of the four experimental groups: GroupC and DC (sham-control group): The abdomen was dissected with a median laparotomy and the liver was collected. GroupDIR: The liver was collected after IR following the abdominal median laparotomy. GroupDIRD: The liver was collected after IR following the abdominal median laparotomy and 30 min of infusion of dexmedetomidine 100 μg/kg ip The deformability measurements were performed in erythrocyte suspensions containing Htc 5% in PBS buffer. Results: The deformability index was signifi cantly increased in diabetic rats, however it was similar in the GroupC and DIRD. It was signifi cantly increased in the GroupDIR when compared to the GroupC, DIRD and DC. The relative resistance was increased in IR models. Conclusion: Erythrocyte deformability was damaged in rats having diabetes and IR injury. This injury might lead to further problems in microcirculation. It was shown that dexmedetomidine may be useful in enhancing the adverse effects of this injury (Tab. 1, Fig. 2

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Anaesthetic management of patients with diabetes mellitus

Cited by 115 publications

References 113 publications

Patient selection in ambulatory anesthesia — An evidence-based review: part II

Patient selection in ambulatory anesthesia — An evidence-based review: part II

Investigation of the effects of propofol and vitamin C administration on erythrocyte deformability in rats with streptozotocin-induced

Effect of dexmedetomidine on erythrocyte deformability during ischemia-reperfusion injury of liver in diabetic rats

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