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麻醉学实践中的低血糖:诊断、预防及管理策略

Hypoglycaemia in anesthesiology practice: Diagnostic, preventive, and management strategies.

作者信息

Kalra Sanjay, Bajwa Sukhminder Jit Singh, Baruah Manash, Sehgal Vishal

机构信息

Department of Endocrinology, Bharti Hospital and BRIDE, Karnal, Haryana, India.

Department of Anaesthesiology and Intensive Care, Gian Sagar Medical College and Hospital, Ram Nagar, Banur, Punjab, India.

出版信息

Saudi J Anaesth. 2013 Oct;7(4):447-52. doi: 10.4103/1658-354X.121082.

Abstract

Diabetes mellitus has emerged as one of the fastest growing non communicable diseases worldwide. Management of diabetic patients during surgical and critically illness is of paramount challenge to anesthesiologist and intensivist. Among its major acute complications, hypoglycemia has been given lesser attention as compared to other major acute complications; diabetic ketoacidosis and hyperosmolar non ketotic coma. However, newer studies and literary evidence have established the serious concerns of morbidity and mortality, both long- and short-term, related to hypoglycemia. basis. Invariably, diabetic patients are encountered in our daily routine practice of anesthesia. During fasting status as well as the perioperative period, it is hypoglycemia that is of high concern to anesthesiologist. Management has to be based on clinical, pharmacological, social, and psychological basis, so as to completely prevent the complications arising from an acute episode of hypoglycemia. This review aims to highlight various aspects of hypoglycemia and its management both from endocrine and anesthesia perspective.

摘要

糖尿病已成为全球增长最快的非传染性疾病之一。在外科手术和危重病期间对糖尿病患者的管理,对麻醉医生和重症监护医生来说是一项至关重要的挑战。在其主要的急性并发症中,与其他主要急性并发症(糖尿病酮症酸中毒和高渗性非酮症昏迷)相比,低血糖受到的关注较少。然而,最新的研究和文献证据已经证实了低血糖在短期和长期内与发病率和死亡率相关的严重问题。在我们日常的麻醉实践中,糖尿病患者总是会遇到。在禁食状态以及围手术期,麻醉医生高度关注的是低血糖。管理必须基于临床、药理学、社会和心理学基础,以完全预防低血糖急性发作引起的并发症。本综述旨在从内分泌和麻醉角度突出低血糖及其管理的各个方面。

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