Anestesia y diabetes / Anesthesia and diabetes mellitus

Julio 8, 2017. No. 2743

Manejo preoperatorio de pacientes con Diabetes Mellitus CLAUDIO NAZAR J. CHRISTIAN HERRERA F, ALEJANDRO GONZÁLEZ A. Rev Chil Cir. Vol 65 - Nº 4, Agosto 2013; pág. 354-359 Resumen La Diabetes Mellitus es una condición crónica de hiperglicemia que afecta al 9,4% de la población chilena. Estudios han encontrado que los pacientes con Diabetes Mellitus tienen mayor probabilidad de requerir cirugía en comparación a la población general. La hiperglicemia que presentan los pacientes se ha relacionado al desarrollo de complicaciones infecciosas y cardiovasculares en el período postoperatorio. Se ha demostrado que el adecuado control glicémico preoperatorio contribuye a disminuir el riesgo de desarrollar dichas complicaciones. Es por eso que se hace fundamental la evaluación preoperatoria para poder conocer los valores de glicemia que presenta el paciente y realizar los exámenes necesarios para determinar las consecuencias sistémicas que ha desarrollado la Diabetes Mellitus. De esta forma podremos realizar modificaciones en los tratamientos que utilizan los pacientes con el fin de optimizar su condición previo a la cirugía. Palabras clave: Diabetes Mellitus 1 y 2, hiperglicemia, hipoglicemiantes orales, insulina, manejo preoperatorio PDF Diabetes mellitus y el anestesiólogo, cuidados perioperatorios Elsa Elisa Jiménez Morales,* Rogelio Sánchez García Revista de Investigación Médica Sur, México Vol. 15, núm. 1, Enero-Marzo 2008 Resumen La diabetes mellitus es uno de los padecimientos con mayor prevalencia, por lo que los médicos involucrados en su manejo antes, durante y después de un acto quirúrgico, deben conocer su terapéutica. Los criterios actuales de diagnóstico para diabetes son: síntomas de diabetes (poliuria, polidipsia, y pérdida de peso inexplicable) más el resultado de una muestra aleatoria mayor o igual a 200 mg/dL de glucosa, glucosa en ayuno (> 8 horas) de 126 mg/dL o mayor. Glucosa mayor o igual a 200 mg/dL 2 horas después de la administración oral de 75 g de glucosa. Los protocolos de manejo perioperatorio de pacientes diabéticos aceptados actualmente son tres y se conocen como; régimen clásico amplio, régimen estricto tipo I y escala móvil. Palabras clave: alabras clave: Diabetes mellitus, cuidados perioperatorios, anestesiología. PDF XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information Encuentro Internacional de Manejo de la Vía Aérea Bariloche. Argentina. Nov 30-Dic 2, 20l7 Información / Information

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org

Diabetes y anestesia / Diabetes and anaesthesia

Julio 7, 2017. No. 2742

Efecto de los diferentes tipos de anestesia en la glucosa intraoperatoria en sangre de pacientes diabéticos Effect of different types of anesthesia on intraoperative blood glucose of diabetic patients: A PRISMA-compliant systematic review and meta-analysis. Li X1, Wang J, Chen K, Li Y, Wang H, Mu Y, Chen Y. Medicine (Baltimore). 2017 Mar;96(13):e6451. doi: 10.1097/MD.0000000000006451. Abstract BACKGROUND: Systematic review which analyzes the impact of different anesthesia on intraoperative blood glucose levels of diabetespatients. METHODS: We searched Medline (via PubMed), Embase, Cochrane Library, Web of Science, Wangfang, CNKI, and CBM database through June 2016, included in randomized controlled trial (RCT), about different anesthesia on intraoperative blood glucose levels in patients with diabetes. Two researchers in 1 group independently screened literatures with eligibility criteria, extracted information, and used RevMan5.3 software to perform meta-analysis. RESULTS: We included 11 trials and performed the meta-analysis with 10 trials. The meta-analysis results suggested that compared with general anesthesia, the combined general-epidural anesthesia has a better glycemic control in intraoperative blood glucose levels (WMD -1.26, 95% confidence interval [CI] -1.77 to 0.76), the epidural anesthesia had no significant effects compared with general anesthesia (WMD -0.74, 95% CI 4.41-2.92), and the combined spinal-epidural anesthesia had no significant effects compared with epidural anesthesia (WMD -0.28, 95% CI -1.02 to 0.46). One study suggested that compared with epidural anesthesia, the combined general-epidural anesthesia can lower blood glucose levels CONCLUSION:: Existing evidence showed that compared with general anesthesia, the combined general-epidural anesthesia has a better glycemic control in intraoperative blood glucose levels. PDF Relación entre el momento de las visitas médicas preoperatorias y la glucosa  del día de la cirugía en la diabetes mal controlada. Relationship between the timing of preoperative medical visits and day-of-surgery glucose in poorly controlled diabetes. Patel SI1, Thompson BM1, McLemore RY1, Temkit M1, Schlinkert RT2, Apsey HA2, Cook CB1. Future Sci OA. 2016 Jun 2;2(2):FSO123. doi: 10.4155/fsoa-2016-0009. eCollection 2016 Jun.Abstract BACKGROUND: This study evaluated referral patterns for preoperative evaluations of patients with poorly controlled diabetes mellitus (DM) and determined whether intervals between evaluations and surgery day were associated with preoperative glucose levels. RESULTS/METHODOLOGY: In this retrospective analysis of DM patients with a hemoglobin A1c level greater than 8.0%, of the 163 patients who underwent preoperative medical evaluation, only 45% were evaluated by endocrinology. Patients who had surgery earlier than 10 days after the preoperative medical evaluation had preoperative glucose levels 18% higher than those of patients who waited more than 10 days. Preoperative outpatient contact with endocrinology was not associated with preoperative glucose level (p = 0.90). CONCLUSION: For poorly controlled DM, more than 10 days are needed to achieve preoperative glycemic control. PDF XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information Encuentro Internacional de Manejo de la Vía Aérea Bariloche. Argentina. Nov 30-Dic 2, 20l7 Información / Information

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org

Anestesia y endocrinopatias / Anaesthesia and endocrinopathies

Julio 4, 2017. No. 2739

Endocrinopatías: las perspectivas actuales y cambiantes en la práctica de la anestesia. Endocrinopathies: The current and changing perspectives in anesthesia practice. Bajwa SJ1, Kaur G1. Indian J Endocrinol Metab. 2015 Jul-Aug;19(4):462-9. doi: 10.4103/2230-8210.159026.Abstract The gateways to advancements in medical fields have always been accessed through the coalition between various specialties. It is almost impossible for any specialty to make rapid strides of its own. However, the understanding of deeper perspectives of each specialty or super specialty is essential to take initiatives for the progress of the other specialty. Endocrinology and anesthesiology are two such examples which have made rapid progress in the last three decades. Somehow the interaction and relationship among these medical streams have been only scarcely studied. Diabetes and thyroid pathophysiologies have been the most researched endocrine disorders so far in anesthesiapractice but even their management strategies have undergone significant metamorphosis over the last three decades. As such, anesthesiapractice has been influenced vastly by these advancements in endocrinology. However, a comprehensive understanding of the relationship between these two partially related specialties is considered to be an essential cornerstone for further progress in anesthesia and surgical sciences. The current review is an attempt to imbibe the current and the changing perspectives so as to make the understanding of the relationship between these two medical streams a little simple and clearer. KEYWORDS: Acromegaly; anesthesia for endocrinopathies; craniopharyngioma; diabetes mellitus; endocrinology; phaeochromocytoma; thyroid crisis PDF XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information Encuentro Internacional de Manejo de la Vía Aérea Bariloche. Argentina. Nov 30-Dic 2, 20l7 Información / Information

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org