[Perioperative management of a patient with transient polyuria]

Perioperative and anesthetic management of a patient with a diabetes insipidus is reported. A 33 year old man was followed by physical therapy after spinal cord injury. At that time polyuria (4300-8600 ml.day-1) and polydipsia developed. His urine output was controlled by DDAVP (desmopressin) preoperatively. As the result of water restriction test and Carter-Robbins test the diagnosis of complete central diabetes insipidus was doubted preoperatively. We investigated the changes of his perioperative body fluids and endocrine responses. The following conclusions are made: 1) The diagnosis of this case is not renal and true diabetes insipidus, but is probably partial or transient diabetes insipidus. 2) These results indicate that endocrine examinations related to AVP secretion are essential.