ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 4 of 44
Up
JMBS 2019, 4(2): 27–32
https://doi.org/10.26693/jmbs04.02.027
Medicine. Reviews

Some Peculiarities of Pre-Operating Preparation of Patients with Diabetes Mellitus to Ophthalmosurgical Interventions

Onishchuk A. Y., Alekseev V. P., Drapalyuk I. A.
Abstract

The question of minimizing intra- and postoperative complications in somatically burdened patients with diabetes mellitus, in order to safely conduct ophthalmic surgical interventions is particularly relevant, due to an increase in the incidence and complications of this disease. The article deals with the problem of pre-operative preparation of patients with diabetes mellitus for ophthalmic surgical interventions with consideration of modern medical approaches. A differentiated individual approach to the preparation of patients with diabetes mellitus for ophthalmologic operations, taking into account their initial somatic state, and their preoperative correction is required when planning anesthesiological measures, taking into account the degree of operational risk. Pre-operative preparation of patients with diabetes mellitus will allow the majority of patients to minimize the possible operational and anesthetic risks, as well as to avoid intra-and postoperative complications. The main objectives of pre-operative preparation include: correction of glycemia, correction of cardio and hemodynamic disorders, correction of renal dysfunction, correction of diabetic neuropathy, correction of anxiety and depressive disorders. There is no consensus on a clear criterion for glycemia in the pre-operative period. Glycemia correction is the necessary measure to reduce pre-operative mortality and postoperative complications, regardless of the diabetic status of the patient. It is advisable to correct hypertension in patients before a planned ophthalmic surgery by the anesthesiologist together with the cardiologist usually 2 weeks before the date of surgery. Correction of renal dysfunction in the period of pre-operative preparation to a certain extent contributes to the prevention of hypoglycemic conditions in the subsequent stages of treatment. Today, somatogenic and psychogenic factors play an important role in the mechanisms of diabetes mellitus. Our work covers not all the problems arising during the work with this category of patients. There is an obvious need for further research in this area to make recommendations for practical work.

Keywords: diabetes mellitus, ophthalmosurgical interventions, pre-operative preparation

Full text: PDF (Rus) 217K

References
  1. Shtemberg LV, Frantseva AP. Sostoyanie problemy patogeneza, etiologii i diagnosticheskikh kriteriev sakharnogo diabeta I tipa (obzor literatury). Mezhdunarodnyy zhurnal prikladnykh i fundamentalnykh issledovaniy. 2014; 9: 98–102. [Russian]
  2. Dedov II. Sakharnyy diabet — opasneyshiy vyzov mirovomu soobshchestvu. Vestnik RAMN. 2012; 1: 7–13. [Russian]
  3. Gadzhimuradov KN, Khagverdiev FT. Obespechenie bezopasnosti patsientov pri vitreoretinalnykh operatsiyakh. Visnik problem biologiyi i meditsini. 2015; 2(123): 17–22. [Russian]
  4. Iskandarova ShT, Nabiev AM, Dzhamalova ShA. Invalidnost vsledstvie oftalmologicheskikh oslozhneniy sakharnogo diabeta i puti eyo profilaktiki. Oftalmol zhurn. 2015; 3: 54–8. [Russian]
  5. Kogan MP, Esina MA. Osobennosti otbora i podgotovki patsientov s sakharnym diabetom 2 tipa k khirurgicheskomu lecheniyu v oftalmokhirurgii. Sovremennye tekhnologii v oftalmologii. 2016; 2: 144–7. [Russian]
  6. American Society of Anesthesiologists: Practice guidelines for sedation and analgesia by non-anesthesiologists: An updated report. Anesthesiology. 2002; 96: 1004–17.
  7. Zarivchatskiy MF, Blinov SA, Denisov SA, dr. Intraoperatsionnaya i perioperatsionnaya bezopasnost v endokrinnoy patologii. Permskiy meditsinskiy zhurnal. 2013; ХХХ(5): 86–92. [Russian]
  8. Noordzij PG, Boersma E, Schreiner F, Kertai MD, Feringa HH, Dunkelgrun M, et al. Increased preoperative glucose levels are associated with perioperative motality in patients undergoing noncardiac, nonvascular surgery. Eur J Endocrinol. 2007 Jan; 156(1): 137–42. https://www.ncbi.nlm.nih.gov/pubmed/17218737. https://doi.org/10.1530/eje.1.02321
  9. Moghissi E, Korytkowski MT, DiNardo M, Einhorn D, Hellman R, Hirsch IB, et. al. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Diabetes Care. 2009; 32(6): 1119-31. https://www.ncbi.nlm.nih.gov/pubmed/19429873. https://www.ncbi.nlm.nih.gov/pmc/articles/2681039. https://doi.org/10.2337/dc09-9029
  10. Joshi G, Chung F, Vann MA, Ahmad S, Gan TJ, Goulson DT, et al. Society for Ambulatory Anesthesia consensus statement on perioperative blood glucose management in diabetic patients undergoing ambulatory surgery. Anesthesia and Analgesia. 2010; 111(6): 1378–87. https://www.ncbi.nlm.nih.gov/pubmed/20889933. https://doi.org/10.1213/ANE.0b013e3181f9c288
  11. Umpierrez GE, Smiley D, Jacobs S, Peng L, Temponi A, Mulligan P, et al. Randomized study of basal-bolus insulin therapy in the inpatient management of patients with type 2 diabetes undergoing general surgery (RABBIT 2 surgery). Diabetes Care. 2011; 34(2): 256–61. https://www.ncbi.nlm.nih.gov/pubmed/21228246. https://www.ncbi.nlm.nih.gov/pmc/articles/3024330. https://doi.org/10.2337/dc10-1407
  12. Mkrtumyan AM. Kardiovaskulyarnye oslozhneniya sakharnogo diabeta 2 tipa i osobennosti korrektsii uglevodnogo obmena. Serdtse. 2013; 6: 268–77. [Russian]
  13. Hanefeld MT, Schönauer M, Forst T. [Glycemic control and cardiovascular benefit: what do we know today?] Dtsch med wochenschr. 2010; 135(7): 301–7. [German] https://www.ncbi.nlm.nih.gov/pubmed/20146161. https://doi.org/10.1055/s-0029-1244853
  14. Skvortsov YuI, Golovacheva TV, Skvortsov VV, Skvortsov KYu. O mekhanizmakh razvitiya bezbolevoy ishemii miokarda u bolnykh sakharnym diabetom. Poliklinika. 2011; 1: 29–32. [Russian]
  15. Askerov MM. Arterialnaya gipertenziya pri sakharnom diabete. Ukrayinskiy zhurnal klinichnoyi ta laboratornoyi meditsini. 2013; 8(2): 4–8. [Russian]
  16. Kendir C, van den Akker M, Vos R, Metsemakers J. Cardiovascular disease patients have increased risk for comorbidity: A cross-sectional study in the Netherlands. Eur J Gen Pract. 2018; 24(1): 45–50. https://www.ncbi.nlm.nih.gov/pubmed/29168400. https://www.ncbi.nlm.nih.gov/pmc/articles/5795764. https://doi.org/10.1080/13814788.2017.1398318
  17. Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M, et al. Task Force Members. Practice guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC). J Hypertens. 2013 Jul; 31(7): 1281-357. https://www.ncbi.nlm.nih.gov/pubmed/23817082. https://doi.org/10.1097/01.hjh.0000431740.32696.cc
  18. Loskutov OA, Shlapak IP, Parkhomenko AN, i dr. Anesteziologicheskoe obespechenie patsientov s soputstvuyushchey arterialnoy gipertenziey. Meditsina neotlozhnykh sostoyaniy. 2012; 7–8: 46–7. [Russian]
  19. Bloomgarden ZT. The heart outcomes prevention evaluation study investigators. Effects of an angiotensin-converting-enzyme inhibitor on cardiovascular events in high-risk patients. New England journal of medicine. 2000; 342: 145-53.
  20. Ukrayinska asotsiatsiya kardiologiv: Rekomendatsiyi Ukrayinskoyi asotsiatsiyi kardiologiv z profilaktiki ta likuvannya arterialnoyi gipertenziyi: Posibnik do Natsionalnoyi programi profilaktiki i likuvannya arterialnoyi gipertenziyi. K; 2008. 80 p. [Ukrainian]
  21. Sakharnyy diabet: ostrye i khronicheskie oslozhneniya. Ed by II Dedov, MV Shestakova. M: MIA; 2011. 480 p. [Russian]
  22. Neymark MI. Anesteziya u bolnykh, stradayushchikh sakharnym diabetom. Zhurnal «Meditsina neotlozhnykh sostoyaniy». 2008; 4(17). Available from: http://www.mif-ua.com/archive/article/6611
  23. Tanashyan MM, Anashyan KV, Antonova KV, i dr. Diabeticheskaya neyropatiya: patogenez, klinika, podkhody k personifikatsirovannoy korrektsii. Meditsinskiy sovet. 2017; 17: 72–80. [Russian]
  24. Starostina EG, Volodina MN, Starostin IV, i dr. Depressiya i sakharnyy diabet kak komorbidnye zabolevaniya. Russkiy meditsinskiy zhurnal. 2017; 22: 1613–20. [Russian]
  25. Abrahamian H, Kautzky-Willer A, Rießland-Seifert A, Fasching P, Ebenbichler C, Hofmann P, Toplak H. Mental disorders and diabetes mellitus. Wien Klin Wochenschr. 2016; 128(Suppl 2): 170–8. https://www.ncbi.nlm.nih.gov/pubmed/27052238. https://doi.org/10.1007/s00508-015-0939-8
  26. Bobrov AE, Volodina MN, Agamamedova IN, i dr. Psikhicheskie rasstroystva u bolnykh sakharnym diabetom 2-go tipa. Russkiy meditsinskiy zhurnal. 2018; 1: 28-33. [Russian]
  27. Moroz SM, Makarova II, Semenikhina VE, i dr. Vozmozhnosti fitoneyroregulyatsii u patsientov s trevozhno-depressivnymi rasstroystvami, obuslovlennymi voennym stressom. Ukr med chasopis. 2015; 4(108): 61-3. [Russian]
  28. Burchinskiy SG. Novye vozmozhnosti fitoterapevticheskoy korrektsii rasstroystva sna. Mistetstvo likuvannya. 2017; 9-10 (145-146): 11-8. [Russian]