Continuing peripheral nerve blocks – benefit for orthopedic patients with diabetes mellitus?

Czech version

Authors: David Doležal; Abdo Islam Saleh
Authors‘ workplace: Klinika anesteziologie, resuscitace a intenzivní medicíny LF UK a FN Hradec Králové, přednosta MUDr. Tomáš Suchý
Published in: Vnitř Lék 2015; 61(6): 559-562
Category:

Předneseno na mezioborovém sympoziu s postgraduálním zaměřením „Diabetik – společný pacient diabetologa a ortopeda“ 10. října 2014 v Hradci Králové.

Overview

There is increasing incidence of diabetes mellitus in population of developed countries. And there is also, together with this fact, an increasing frequency of surgical not only orthopedic procedures for diabetic complications or for other reasons. However, thanks to modern sophisticated perioperative approaches, diabetes itself is no longer main risk factor for worsening of perioperative morbidity and mortality. The organ complications of diabetes still remain the crucial for patients’ outcome. The individual approach to each patient is important when we are planning anesthesiological perioperative strategy. Assessment of long term diabetes compensation before elective surgical procedures, assessment and optimization of organ functions with searching for possible secondary complications of diabetes is also crucial. Generally, it is necessary to maintain compensation of diabetes through the whole perioperative period, avoid episodes of hypotension and tissue hypoperfusion and all anesthesiological interventions have to be targeted to rapid recovery (chronic medication, oral feeding and early rehabilitation). Technics of regional anesthesia and peripheral nerve blocks particularly, may be very useful for the objective especially for orthopedic patients.

Key words:
anesthesia – diabetes mellitus – perioperative period – peripheral nerve blocks

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