Karhunen U, Summanen P, Laatikainen L
Acta Ophthalmol (Copenh). 1987 Apr;65(2):190-6. doi: 10.1111/j.1755-3768.1987.tb06999.x.
Problems related to general anaesthesia of 109 consecutive vitrectomies performed on diabetic patients were retrospectively reviewed. On the morning of surgery a normal or a slightly reduced dose of the patient's regular insulin was administered subcutaneously. The amount of intravenous infusion, mostly 5% glucose, was calculated according to the pre-operative urine volume. After surgery, hypoglycaemic (less than 3 mmol/l) values were seen in less than 11% of the patients, and high glucose in less than 30%; 20% had a mild ketoacidosis post-operatively. Difficulties in tracheal incubation was encountered in 10%. Three patients complained of chest pain after surgery, and in one of them a myocardial infarction was diagnosed. Forty-one per cent of the patients complained of nausea or vomited in the afternoon after surgery, and 21% had difficulties in urination the night after surgery. Two of four patients with peritoneal dialysis complained of stomach pain post-operatively. There was no significant association between recurrent vitreous haemorrhage and blood glucose concentration or arterial blood pressure in the early post-operative period.
回顾性分析了109例连续接受玻璃体切除术的糖尿病患者全身麻醉相关问题。手术当天早晨，皮下注射患者常规剂量的胰岛素，剂量正常或略减。静脉输液量主要为5%葡萄糖，根据术前尿量计算。术后，不到11%的患者出现低血糖（低于3 mmol/l），不到30%的患者血糖过高；20%的患者术后出现轻度酮症酸中毒。10%的患者气管插管困难。3例患者术后诉胸痛，其中1例诊断为心肌梗死。41%的患者术后下午诉恶心或呕吐，21%的患者术后当晚排尿困难。4例接受腹膜透析的患者中有2例术后诉胃痛。术后早期复发性玻璃体出血与血糖浓度或动脉血压之间无显著关联。
