Influence of diabetes mellitus on changes in plasma osmotic pressure during bowel preparation in patients undergoing radical resection for colon cancer / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the influence of diabetes mellitus on changes in plasma osmotic pressure during bowel preparation in patients undergoing radical resection for colon cancer.Methods Sixty patients,of ASA physical status Ⅰ or Ⅱ,aged 40-60 yr,weighing 50-75 kg,scheduled for elective radical resection for colon cancer,were included in the study.Of the 60 patients,30 patients with type 2 diabetes mellitus served as test group (group DM),and 30 patients without diabetes mellitus served as control group (group C).Polyethylene glycol electrolyte powder was given orally for bowel preparation before surgery.In the early morning of the day on which preoperative preparation was performed (T1) and before opening venous channels after admission to the operating room (T2),venous blood samples were taken for determination of plasma colloid osmotic pressure (COP) and concentrations of plasma electrolytes (Na+,Cl-,K+) and blood glucose.Thirst was assessed using visual analogue scales at T1 and T2.Results Compared with the baseline value at T1,the plasma COP and degree of thirst were significantly increased at T2 in C and DM groups,blood glucose concentrations were decreased at T2 in group DM,and no significant changes were found in the plasma concentrations of electrolytes at T2 in both groups.Compared with group C,blood glucose concentrations were significantly increased,and no significant changes were found in the plasma concentrations of electrolytes at T1,2,no significant change was found in plasma COP and degree of thirst at T1,and the degree of thirst was decreased at T2,while the plasma COP was increased at T2 in group DM.Conclusion After bowel preparation in patients undergoing radical resection for colon cancer,although the thirsty sensation of the patients with diabetes mellitus is decreased,the plasma COP is obviously increased; thus infusion of appropriate crystalloid solution instead of colloid solution is required in case hyperosmolar coma develops.