Cardiac Sympathetic Tone in Anaesthetized Diabetics

Tsueda, Kentaro; Huang, K. C.; Dumont, Stephen W.; Wieman, T. Jeffery; Mh, Thomas; Heine, Michael F.

doi:10.1097/00132586-199106000-00002

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“…Bolus infusion of ephedrine, phenylephrine, or atropine sulfate may be used for transient improvement of hemodynamics. However, these drugs may not be efficacious in maintaining systemic hemodynamics, as shown in the report by Tsueda et al [11], which showed that the atropine-induced heart rate in diabetics was significantly lower than that in nondiabetics (95 ± 14 beats/min vs. 109 ± 12 beats/min, respectively), the heart rate being closely related to preoperative orthostatic diastolic blood pressure changes.…”

Section: Hemodynamic Instabilitymentioning

confidence: 97%

Anesthetic considerations in diabetic patients. Part II: intraoperative and postoperative management of patients with diabetes mellitus

Kikuchi

2010

J Anesth

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Some studies have reported that tight glycemic control in diabetic patients undergoing major surgery improves perioperative morbidity and mortality rates. Recently, however, large randomized studies have shown such control increases the mortality rate, since aggressive glycemic control induces more frequent incidences of hypoglycemia. Diabetic patients have cerebral complications during the perioperative period more often than their nondiabetic counterparts. Further, anesthetic agents have some effects on cerebral circulation and cerebrovascular carbon dioxide reactivity. Hence, anesthesiologists should have adequate knowledge about anesthetic agents that maintain the integrity of the cerebral circulation. Patients with diabetes mellitus (DM) have an increased susceptibility to perioperative infections. Recent work confirmed that a combination of intravenous and subcutaneous insulin as a glucose management strategy had beneficial effects identical with intravenous insulin therapy alone on the reduction of infection rates during the postoperative period.

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Section: Hemodynamic Instabilitymentioning

confidence: 97%

Anesthetic considerations in diabetic patients. Part II: intraoperative and postoperative management of patients with diabetes mellitus

Kikuchi

2010

J Anesth

View full text Add to dashboard Cite

show abstract

Cardiac Sympathetic Tone in Anaesthetized Diabetics

Cited by 1 publication

References 0 publications

Anesthetic considerations in diabetic patients. Part II: intraoperative and postoperative management of patients with diabetes mellitus

Anesthetic considerations in diabetic patients. Part II: intraoperative and postoperative management of patients with diabetes mellitus

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