Concomitant problems to the anaesthesia of diabetic vitrectomy patients

Problems related to general anaesthesia of 109 consecutive vitrectomies performed on diabetic patients were retrospectively reviewed. On the morning of surgery a normal or a slightly reduced dose of the patient's regular insulin was administered subcutaneously. The amount of intravenous infusion, mostly 5% glucose, was calculated according to the pre-operative urine volume. After surgery, hypoglycaemic (less than 3 mmol/l) values were seen in less than 11% of the patients, and high glucose in less than 30%; 20% had a mild ketoacidosis post-operatively. Difficulties in tracheal incubation was encountered in 10%. Three patients complained of chest pain after surgery, and in one of them a myocardial infarction was diagnosed. Forty-one per cent of the patients complained of nausea or vomited in the afternoon after surgery, and 21% had difficulties in urination the night after surgery. Two of four patients with peritoneal dialysis complained of stomach pain post-operatively. There was no significant association between recurrent vitreous haemorrhage and blood glucose concentration or arterial blood pressure in the early post-operative period.