RESUMO
The article is devoted to the existence of the problem of intraoperative provide patients with concomitant diabetes mellitus: a disease is not diagnosed in time, it increases the probability of death in the performance of surgery by 50%, where as the timely prevention and preparation reduces the chance of developing specific complications to the level of patients with the general population. The paper discusses the recommendations developed by the British Association ofEndocrinologists 2011 and Russia in 2015, as well as the Association ofAnaesthetists of Great Britain and Ireland (2015), provides practical recommendations for the preoperative preparation, anesthetic and resuscitation provide patients with concomitant diabetes mellitus.
Assuntos
Diabetes Mellitus , Monitorização Intraoperatória/métodos , Assistência Perioperatória/métodos , Guias de Prática Clínica como Assunto , Procedimentos Cirúrgicos Operatórios , Glicemia/análise , Diabetes Mellitus/sangue , Diabetes Mellitus/tratamento farmacológico , Hemoglobinas Glicadas/análise , Humanos , Infusões Intravenosas , Insulina/administração & dosagem , Insulina/uso terapêuticoRESUMO
PURPOSE: To study the possibility of desflurane use for induction of anesthesia. MATERIALS AND METHODS: We analysed the intra- and immediate postoperative periods in 125 patients. Depending on the intended anesthesia method patients were randomised (the method of the envelopes) and included in one of two study groups: 1--volatile desflurane-based anesthesia (n = 62); 2--volatile sevoflurane-based anesthesia (n = 63). RESULTS: Desflurane based anesthesia led to apnea until the installation of laryngeal mask in 94.5% of patients (of 54), for whom a completion of inhalation induction was possible, whereas sevoflurane based anesthesia.led to apnea occurred only in one patient (1.6%). CONCLUSIONS: "Step up" desflurane-based inhalational induction and sevoflurane-based maximum concentration inhalational induction "without primaryfilling of the circuit" showed no significant in time necessary for achieving an anesthetic concentration essential for LMA installation. In both groups it was 3-5 min. desflurane-based volatile induction with addition of fentanyl led to apnea in 97% of patients and associates with a higher risk of bronchospasm.
