title: [Anesthetic management of pediatric patients with insulinoma using continuous glucose monitoring].
abstract: Insulinomas are rare tumors, the incidence of which is 1-2 per million. Patients with insulinomas present with symptoms of hypoglycemia secondary to insulin hypersecretion. Surgical resection is a treatment of choice and offers the only chance of cure. The important points in anesthesia are the precaution against hypoglycemia until tumor resection and the control of rebound hyperglycemia soon after tumor resection. We report the anesthetic management of a 5-year-old patient with insulinoma. Soon after the induction of anesthesia, the continuous glucose monitoring was commenced. Until the tumor resection, 10% glucose infusion was required to avoid hypoglycemia. Then, insulin infusion was continued to maintain blood glucose level around 150 mg x dl(-1). All glucose management was guided with continuous glucose monitoring. This is a first case report to show the feasibility and usefulness of continuous glucose monitoring in management of pediatric insulinoma patients. As the blood glucose was dramatically altered during perioperative period, frequent blood glucose measurements or continuous glucose monitoring is mandatory during perioperative period of insulinoma resection.
authors.affiliation: Department of Anesthesiology and Resuscitology, Okayama University Hospital, Okayama.
authors.forename: Motoko
authors.initials: M
authors.lastname: Manabe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Morimatsu
authors.forename: Moritoki
authors.initials: M
authors.lastname: Egi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Suzuki
authors.forename: Ryuji
authors.initials: R
authors.lastname: Kaku
authors.forename: Masaki
authors.initials: M
authors.lastname: Matsumi
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Morita
mesh_terms: D000758:Anesthesia; D001786:Blood Glucose / Q000032:analysis*; D002675:Child, Preschool; D005260:Female; D005947:Glucose / Q000008:administration & dosage; D006801:Humans; D007003:Hypoglycemia / Q000517:prevention & control; D007340:Insulinoma / Q000601:surgery*; D007431:Intraoperative Complications / Q000517:prevention & control; D016343:Monitoring, Intraoperative; D010190:Pancreatic Neoplasms / Q000601:surgery*; D019990:Perioperative Care
chemical_list: D001786:Blood Glucose; D005947:Glucose