[Anaesthesia and post-operative care in diabetic patients. Constant rate insulin infusion throughout surgery...

In 10 diabetic patients about to undergo surgical procedures requiring prolonged fasting, a constant rate infusion of glucose (200 g/24 hours) and insulin (2 units/hour) was set up on the morning of the operation. Seven of these patients were insulin-dependent. Throughout the pre-, per- and post-operative periods blood glucose levels were monitored and kept between 0,9 and 1,75 g/l through adjustment of insulin dosage by half units/hour. Treatment lasted from 2 to 7 days. The highest mean doses of insulin were given, and the greatest disparity of results was observed, during the first 24 hours following surgery. Insulin requirements were thereafter stable. This technique simplifies anaesthesia and post-operative care in diabetic patients. The operation time does not need to be precisely determined, small doses of insulin are easily adjusted, insulin therapy is safely and regularly maintained before, during and after surgery, and return to the initial maintenance dosage is facilitated by the disappearance of residual insulin within 3 to 5 minutes from the end of the infusion period.