Document Detail


Diabetic autonomic neuropathy: abnormal cardiovascular reactions under general anesthesia.
MedLine Citation:
PMID:  2280579     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The influence of diabetic autonomic neuropathy upon the behavior of the circulatory system was investigated in 56 patients who had undergone ophthalmological surgery. A standardized test combination (variability in heart rate during deep breathing. Valsalva ratio, 30:15 ratio, change in blood pressure from lying to standing, sustained handgrip test) was used to study the patients' cardiovascular reflectory reactions. The patients were then divided into the following groups: Group I, non-diabetics. Group II, diabetics without autonomic neuropathy. Group III, diabetics with autonomic neuropathy. The anesthetic (induction by barbiturates and conduction by inhalation agents) and the surgical procedure (pars plana vitrectomy) were standardized and always identical. During anesthesia patients in group III experienced hypotensive reactions (systolic blood pressure below 90 mm Hg) significantly more often (72.2%) than patients in group I (25%). In order to achieve stability in blood pressure the patients of group III had to be given vasoactive drugs much more often (77.8%) than the patients of group I (12.5%) and those of group II (35.7%). We found a significant correlation between the degree of autonomic dysfunction and the largest drop in blood pressure under narcosis (r = -0.60, P less than 0.001). However, marked variability in heart rate and cardiac rhythm disorders during anesthesia were seen only in patients of groups I and II. These results prove the atypical hemodynamic behavior and especially the extreme instability in blood pressure in diabetic autonomic neuropathy under general anesthesia. Therefore we consider it to be very helpful to check the cardiovascular reflectory status of diabetics preoperatively.
Authors:
D Knüttgen; D Weidemann; M Doehn
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Klinische Wochenschrift     Volume:  68     ISSN:  0023-2173     ISO Abbreviation:  Klin. Wochenschr.     Publication Date:  1990 Dec 
Date Detail:
Created Date:  1991-03-08     Completed Date:  1991-03-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  2985205R     Medline TA:  Klin Wochenschr     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  1168-72     Citation Subset:  IM    
Affiliation:
Abteilung für Anaesthesiologie, Städtische Krankenanstalten Köln-Merheim.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anesthesia, General*
Arrhythmias, Cardiac / etiology
Autonomic Nervous System Diseases / complications,  physiopathology*
Blood Pressure
Cardiovascular System / physiopathology*
Diabetic Neuropathies / complications,  physiopathology*
Female
Heart Rate
Hemodynamics
Humans
Hypotension / etiology
Male
Middle Aged

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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