Haemodynamic response to induction, laryngoscopy and tracheal intubation in diabetic and non-diabetic patients.
OBJECTIVE
Presence of autonomic neuropathy in diabetic patients can alter the haemodynamic response to induction and tracheal intubation. This trial was conducted to compare this response in 30 non-diabetic (control group) and 30 diabetic patients including both insulin and non-insulin dependent.


METHODS
A prospective, age matched case controlled study was conducted at the Aga Khan University Hospital, for one year. After pre-medication with tablet midazolam 7.5 mgs orally, patients received pethidine 0.8 mg kg(-1), thiopentone sodium 4 to 5 mg kg(-1) for induction and vecuronium 0.1 mg kg(-1) to facilitate tracheal intubation. Following manual ventilation with isoflurane 0.8% in oxygen 33% and nitrous oxide 66%, laryngoscopy and tracheal intubation was performed. Blood pressure (systolic, diastolic and mean) and heart rate responses were measured for 10 minutes.


RESULTS
The systolic arterial pressure dropped by 9% after induction and rose by 16% after intubation in nondiabetics compared to 12% drop after induction and a rise of 10% after intubation in diabetics. No difference was seen in diastolic blood pressure which increased by 27% in ND compared to 22% in DB groups. The heart rate rose by 27% in non-diabetics compared to 17% in diabetics after intubation.


CONCLUSIONS
The systolic, diastolic and mean blood pressure response was similar in the two groups. A greater fall in SAP was observed post intubation in the DB group. A significant difference was observed in the heart rate response which was less in the diabetic group.
Khan
Asif Ali
AA
Department of Anaesthesia, Aga Khan University, Karachi, Pakistan.
Khan
Fauzia Anis
FA
D000759:Adjuvants, Anesthesia / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D018685:Anesthetics, Inhalation / Q000627:therapeutic use; D018686:Anesthetics, Intravenous; D016022:Case-Control Studies; D003971:Diastole / Q000187:drug effects; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D007530:Isoflurane / Q000627:therapeutic use; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008614:Meperidine / Q000627:therapeutic use; D008874:Midazolam / Q000627:therapeutic use; D008875:Middle Aged; D003473:Neuromuscular Nondepolarizing Agents / Q000627:therapeutic use; D009609:Nitrous Oxide / Q000627:therapeutic use; D010100:Oxygen; D011446:Prospective Studies; D013599:Systole / Q000187:drug effects; D013997:Time Factors; D055815:Young Adult
D000759:Adjuvants, Anesthesia; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D008614:Meperidine; D007530:Isoflurane; D009609:Nitrous Oxide; D008874:Midazolam; D010100:Oxygen