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Hyperglycemic hyperosmolar nonketotic coma following diazoxide, anesthesia and operation
Anesthesia and Analgesia
|July 1, 1977
Summary
Unsuspected hyperglycemia, a dangerous rise in blood sugar, led to prolonged coma after anesthesia in a nondiabetic patient. This condition may result from combined drug effects, anesthesia, and surgical stress, necessitating blood glucose monitoring.
Area of Science:
- Anesthesiology
- Pharmacology
- Endocrinology
Background:
- General anesthesia and surgical stress can impact glucose metabolism.
- Certain medications may influence blood glucose levels.
- Hyperglycemic hyperosmolar nonketotic coma is a serious complication.
Observation:
- A nondiabetic patient experienced prolonged postanesthetic coma.
- The patient was receiving intravenous diazoxide and furosemide.
- Unsuspected hyperglycemia was identified as the cause.
Findings:
- The combination of diazoxide, furosemide, general anesthesia, and surgical stress was postulated to cause hyperglycemia.
- This drug-induced hyperglycemia can lead to severe metabolic disturbances.
Implications:
- Blood glucose monitoring is crucial during and after general anesthesia in at-risk patients.
- Awareness of potential drug interactions affecting glucose is important for clinicians.
- Early detection and management of hyperglycemia can prevent serious complications like coma.