Xi Chunhua, Pan Chuxiong, Li Tianzuo
Department of Anesthesiology, Beijing Tongren Hospital, Capital Medical University, Dongjiaominxiang 1, Dongchen District, Beijing, 100730, China.
Department of Anesthesiology, Beijing Shijitan Hospital, Capital Medical University, Tieyilu 10, Yangfangdian, Haidian District, Beijing, 100038, China.
BMC Anesthesiol. 2018 Apr 20;18(1):45. doi: 10.1186/s12871-018-0510-z.
Hypoglycemia is one of the most fatal complications during the perioperative period. General anesthesia or sedation can mask a hypoglycemia-altered mental status. Acute hypoglycemia might result in permanent brain injury. There is no way to detect hypoglycemia during general anesthesia, except for intermittent blood glucose monitoring.
Hypoglycemia is associated with changes in electroencephalogram readings. Here, we report two cases of patients with an abnormally low Bispectral Index (BIS) associated with diabetic retinopathy surgery, one in the recovery stage of general anesthesia and the other in the maintenance of general anesthesia. Hemodynamics were stable. Severe hypoglycemia (1.6 mmol/L and 2.2 mmol/L) was then detected. BIS increased with the correction of severe hypoglycemia.
For diabetic patients, when the intraoperative BIS value is abnormally low, hypoglycemia should be considered. Severe hypoglycemia may be presented in BIS monitoring during general anesthesia.
低血糖是围手术期最致命的并发症之一。全身麻醉或镇静可掩盖低血糖引起的精神状态改变。急性低血糖可能导致永久性脑损伤。除了间歇性血糖监测外，在全身麻醉期间没有办法检测低血糖。
低血糖与脑电图读数的变化有关。在此，我们报告两例糖尿病视网膜病变手术患者出现异常低双谱指数（BIS）的病例，一例在全身麻醉恢复期，另一例在全身麻醉维持期。血流动力学稳定。随后检测到严重低血糖（分别为1.6 mmol/L和2.2 mmol/L）。随着严重低血糖的纠正，BIS升高。
对于糖尿病患者，当术中BIS值异常低时，应考虑低血糖。全身麻醉期间BIS监测可能出现严重低血糖。
