Diabetes mellitus: Implications for the anaesthesiologist

Current Opinion in Anaesthesiology

Volumn 9, Issue 3, 1996, Pages 247-253

  Raucoules Aimé, Marc ^a,b   Grimaud, Dominique ^a  

^a Centre Hospitalier de Nice (06)   (France)

^b University Hospital of Nice University of Nice Sophia Antipolis   (France)

Author keywords

[No Author keywords available]

Indexed keywords

CATECHOLAMINE DERIVATIVE; INSULIN;

ANESTHESIA; AUTONOMIC NEUROPATHY; CARDIOVASCULAR DISEASE; DIABETES MELLITUS; HEART RATE; HEMODYNAMICS; HORMONAL REGULATION; HUMAN; METABOLISM; MONITOR; NON INSULIN DEPENDENT DIABETES MELLITUS; POSTOPERATIVE COMPLICATION; PREOPERATIVE EVALUATION; PRIORITY JOURNAL; QT INTERVAL; RESPIRATORY TRACT DISEASE; SHORT SURVEY; STRESS;

EID: 0029977081     PISSN: 09527907     EISSN: None     Source Type: Journal    
DOI: 10.1097/00001503-199606000-00013     Document Type: Short Survey

References (20)

1. Burgos LG, Ebert TJ, Asiddao C, Turner LA, Pattison CZ, Wang-Cheng R, Kampine JP: Increased intraoperative cardiovascular morbidity in diabetics with autonomic neuropathy. Anesthesiology 1989, 70:591-597
2. Latson TW, Ashmore TH, Reinhart DJ, Klein KW, Giesecke AH: Autonomic reflex dysfunction in patients presenting for elective surgery is associated with hypotension after anaesthesia induction. Anesthesiology 1994, 80:326-337. The authors investigated a wide variety of clinical conditions affecting the ANS. These medical conditions are frequently associated with diabetes mellitus. Preoperative tests of autonomic function included standard autonomic tests and spectral analysis of heart rate variability.
3. Oikkonen M: Diabetic autonomic neuropathy and the haemodynamic actions of vecuronium and pancuronium during vitrectomy. Acta Anaesthesiol Scand 1995, 39:352-355.
4. Kirvelä M, Scheinin M, Lindgren L: Haemodynamic and catecholamine responses to induction of anaesthesia and tracheal intubation in diabetic and non-diabetic uraemic patients. Br J Anaesth 1995, 74:60-65. This study investigates the cardiovascular and catecholamine responses to anaesthesia in diabetic patients with nephropathy. It found an increased systolic pressor response to tracheal intubation that may be caused by increased sensitivity to catecholamines and loss of autonomic control.
5. Lugrin D, Raucoules-Aimé M, Ben Milled M, Grimaud D: Catecholamines profile during anaesthesia in diabetic patients with autonomic neuropathy [Abstract]. Br J Anaesth 1994 72:119.
6. Davis M, Mellman M, Friedman S, Chang CJ, Shamoon H: Recovery of epinephrine response but not hypoglycemic symptom threshold after intensive therapy in type 1 diabetes. Am J Med 1994, 97:535-542.
7. Ewing DG, Neilson JMM: QT interval length and diabetic autonomic neuropathy. Diabetic Med 1990, 7:23-26.
8. Goning JM, Kadrofske MM, Schmaltz S, Bastyr EJ, Vinik AI: Corrected Q-T interval prolongation as diagnostic tool for assessment of cardiac autonomic neuropathy in diabetes mellitus. Diabetes Care 1990, 13:68-71.
9. Kirvelä M, Yli-Hankala A, Lindgren L: QT dispersion and autonomic function in diabetic and non-diabetic patients with renal failure. Br J Anaesth 1994, 73:801-804. QT dispersion is increased in diabetic uraemic patients with severe autonomic neuropathy. The authors conclude that the calculation of QTc dispersion from the preoperative electrocardiogram and the use of standard autonomic tests are useful ways of estimating the perioperative risk of cardiac arrhythmias and sudden death.
10. Rose DK, Cohen MM, Wigglesworth DF, DeBoer DP: Critical respiratory events in the postanesthesia care unit. Patient, surgical, and anesthetic factors. Anesthesiology 1994, 81:410-418.
11. Ebert TJ: Preoperative evaluation of the autonomic nervous system. In Advances in Anesthesia. Edited by TJ Gallagher. Mosby-Year Book, Inc; 1993, 10:49-68.
12. Brogard JM, Diemunsch P, Guillausseau PJ, Grimaud D, Lambert H, Massabie P, Scherpereel Ph: Diabetes and anaesthesia: perioperative management of the diabetic patient [in French]. Ann Fr Anesth Réanim 1995, 6:523-531.
13. Hall GM: Insulin administration in diabetic patients-return of the bolus? [Editorial]. Br J Anaesth 1994, 72:1-2.
14. Raucoules-Aimé M, Ichai C, Roussel LJ, Romagnan MJ, Gastaud P, Dolisi C, Grimaud D: Comparison of two methods of i.v. insulin administration in the diabetic patient during the perioperative period. Br J Anaesth 1994, 72:5-10.
15. Raucoules-Aimé M, Lugrin D, Boussofara M, Gastaud P, Dolisi C, Grimaud D: Intraoperative glycaemic control in non-insulin-dependent diabetes and insulin-dependent diabetes. Br J Anaesth 1994, 73:443-449.
16. Raucoules-Aimé M, Labib Y, Levraut J, Gastaud P, Dolisi C, Grimaud D: Use of i.v. insulin in well-controlled non-insulin-dependent diabetics undergoing major surgery. Br J Anaesth 1996, 76:198-202. This study indicates that the 'no insulin, no glucose' regimen is a simple, effective way to control blood glucose in well-controlled NIDDM patients, provided blood glucose is measured frequently and insulin is used appropriately.
17. Raucoules-Aimé M, Roussel LJ, Rossi D, Gastaud P, Dolisi C, Grimaud D: Effect of severity of surgery on metabolic control and insulin requirements in insulin-dependent diabetic patients. Br J Anaesth 1995, 74:231-233.
18. Barker JP, Robinson PN, Vafidis GC, Burrin JM, Sapsed-Byrne S, Hall GM: Metabolic control of non-insulin-dependent diabetic patients undergoing cataract surgery: comparison of local and general anaesthesia. Br J Anaesth 1995, 74:500-505. This study compared the effects of local and general anaesthesia on metabolic control in NIDDM patients undergoing cataract surgery. Local anaesthesia maintained glucose homeostasis and prevented the increases in cortisol and glucose observed under general anaesthesia.
19. Raucoules-Aimé M, Boussofara M, Lugrin D, Chave S, Grimaud D: Association clonidine-etomidate and insulin requirements in diabetics during minor surgery [Abstract]. Br J Anaesth 1994, 72:122.
20. Coeurveille D, Raucoules-Aimé M, Lugrin D, Grimaud D: Clonidine given as premedication decreases insulin requirements in diabetics during surgery [in French]. Ann Fr Anesth Réanim 1994, 13:127.