RE: Anaesthesia and Diabetic Patients

cheryl aslett — Tue, 04 Jul 2017 13:16:17 GMT

Please share the website address you found.

Many thanks. x

Re: Anaesthesia and Diabetic Patients

Siobhan Steven — Sun, 24 Mar 2013 02:52:06 GMT

A few points to remember:

Pre GA bloods should be done the day before Sx (therefore you are not waiting on results the day of Sx), assuming you have in house haematology, if you send it off site you should get the patient in to draw blood allowing enough time to receive results. Prime concerns are potential ketoacidosis if the diabetes is not controlled.

Anaesthatise early in the day to minimise the duration of fasting the patient, minimising the chance of a diabetic crisis and time for the patient to recover.

Do a BG (Blood Glucose) prior to insulin and premed, if result is below 5.5mmol/l do not administer insulin, commence 2.5-5% Dextrose infusion. If result is 5.5-11 mmil/l administer 1/4 usual insulin dose and begin Dextrose infusion, if its above 11mmol/l give 1/2 the insulin dose and do not administer any Dextrose until the BG is below 8.3mmol/l.

Do regular BG throughout Sx, every 15 mins. I use a lingual vein (assuming you can get to the head) and use an insulin syringe do draw a couple of drops of blood or sometimes its enough just to do a pinprick and place the glucometer right at the vein, you can also use ear veins on cats (or dogs) otherwise any vein will do, you can place a IV catheter to pull a few drops of blood each time but don't use it for anything else, this can be helpful with cats as they are harder to access/ stick when covered in drapes....

You will be aiming for a result between 8.3-14mmol/l, if its below 8.3mmol/l administer 2.5-5% Dextrose infusion, from 8.3mmol/l-14mmol/l continue the infusion, if BG is above 14mmol/l reduce the infusion, above 16mmol/l suspend the infusion. The Dextrose infusion is administered at 2-4 ml/kg/hr, adjusting to amend to raise or lower BG.

Use short acting agents throughout, e.g a Propofol TIVA if necessary to ensure rapid recovery from GA and encourage patient to eat ASAP after procedure. Continue to monitor BG, every 30 mins post Op. It may be helpful to administer local analgesia where appropriate, epidural, line blocks, intercostal blocks etc...we use a 'multi modal' approach to or anaesthesia/analgesia.

Maintain all elements of patient support, e.g thermo support to minimise hypothermia, express bladder at the end of Sx and continue to monitor urination and fluids to support BP. If there is a delay in eating support may need to be provided with Dextrose and potassium supplementation.

We are lucky to have and ICU so all these patients will be observed overnight at the very least before going home.

Hope this helps...

Re: Anaesthesia and Diabetic Patients

Steph Worsley — Sat, 23 Mar 2013 21:06:47 GMT

what sort of info are you after??

Re: Anaesthesia and Diabetic Patients

J.R. Rimmer RVN — Sat, 23 Mar 2013 19:42:25 GMT

Just found a good website, replies are still welcome though :)