title: Haemodynamic response to induction, laryngoscopy and tracheal intubation in diabetic and non-diabetic patients.
abstract: 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.
authors.affiliation: Department of Anaesthesia, Aga Khan University, Karachi, Pakistan.
authors.forename: Asif Ali
authors.initials: AA
authors.lastname: Khan
authors.forename: Fauzia Anis
authors.initials: FA
authors.lastname: Khan
mesh_terms: 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
chemical_list: D000759:Adjuvants, Anesthesia; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D008614:Meperidine; D007530:Isoflurane; D009609:Nitrous Oxide; D008874:Midazolam; D010100:Oxygen