RESUMO
The metabolic changes in connection with fasting, anaesthesia and surgery in diabetic patients and non-diabetic patients are reviewed. Various perioperative forms of treatment are described. The forms of treatment most commonly employed are infusion of glucose-insulin-potassium (GIK) and subcutaneous administration of insulin followed by infusion of glucose (KON). The more intensive GIK regime provides the diabetic patient with a biochemical regulation which resembles that found in non-diabetics. It has not been proved whether this marginal regulation influences the well-being, morbidity or mortality of the patients. In critically ill patients or patients with concurrent diseases, the GIK regime is recommended as this provides optimal regulation of the diabetes. In the remaining patients, local conditions will influence the choice of form of treatment.
Assuntos
Diabetes Mellitus Tipo 1/cirurgia , Diabetes Mellitus Tipo 2/cirurgia , Cuidados Intraoperatórios/métodos , Anestesia , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/complicações , Jejum/sangue , Glucose/administração & dosagem , Humanos , Insulina/administração & dosagem , Potássio/administração & dosagem , Pré-MedicaçãoRESUMO
Postanaesthetic arousal time was studied in elderly patients given either glycopyrrolate 0.01 mg kg-1 or atropine 0.02 mg kg-1 before antagonism of neuromuscular blockade. Forty patients (age greater than or equal to 65 yr) undergoing elective hip replacement were included in a double-blind study. Arousal was scored for 2 h after recovery using a modified scoring system. No difference in arousal time was found between the two groups.
