ABSTRACT
Hyperinsulinism caused by a functioning islet cell tumor of the pancreas is an uncommon but well established metabolic entity which can usually be diagnosed accurately. We treated a patient with functioning insulinoma recently. The outline of the particular management given for the course of the anesthesia of the patient was as follows: 1) Control of blood glucose a) pre- and intraoperative hypoglycemia; Glucose was administered through intravenous drip or orally. b) postoperative transient hyperglycemia; Insulin was administered if necessary and a small amount of glucose uptake, occurred. 2) Anesthetics, and supplemental drugs Drugs with no or little effect in increasing blood glucose were used. 3) Beta-adrenergic blockers These drugs were not used in the hypoglycemic state because of potentiating insulin activity.
Subject(s)
Humans , Adenoma, Islet Cell , Adrenergic beta-Antagonists , Anesthesia , Anesthetics , Blood Glucose , Glucose , Hyperglycemia , Hyperinsulinism , Hypoglycemia , Infusions, Intravenous , Insulin , Insulinoma , PancreasABSTRACT
A 13-year-old male developed cardiac arrest and pulmonary edema during an elective surgery for chronic mastoiditis following a local injection of 0. 1 ml of 1: 1000 adrenaline under general anesthesia. After several days, 14-year-old male developed same episode during tonsillectomy under local anesthesia at ENT out patient department. They showed an immediate and favorable response to treatment with CPPB, rapid digitalization, fluid therapy, etc. The clinical course and pathophysiology of adrenaline induced pulmonary edema will be discussed.