ŞƏKƏRLİ DİABETİ OLAN XƏSTƏLƏRDƏ OFTALMOLOJİ CƏRRAHİ ƏMƏLİYYATLAR ZAMANI ANESTEZİOLOJİ TƏMİNAT (KLİNİKİ HAL)

Abstract

SUMMARY

In the preparation of patients with diabetes to ophthalmic surgery in the case of determination of glucose in venous blood of 8-9 mmol / l, should be kept under observation for 1-2 days before surgery. In the perioperative period in this group the level of glucose in venous blood was 6.10 mmol /l and the method of neuroleptanesthesia with potentiated local anesthesia is recomended. In the postoperative period the glucose level in the venous blood should be determined every 4-6 hours and should be close in meaning to the indicators in the preoperative period.
However, in the major surgeries (orbitotomy, enucleation, removal of tumors of eyelids and conjunctiva, evisceration, exenteration) to the diabetic patients in the preoperative period compare with the in contrast to patients undergoing small and short-term ophthalmic surgical interventions insulin appointment is necessary. This group of patients is recommended to use a high-speed, non-depolarizing muscle relaxant, multicomponent balanced anesthesia with controlled breathing in order to prevent the development of perioperative ketoacidotic hyperosmolar coma.
In the postoperative period during frst 3 days every 3-5 hours it is necessary to control the level of glucose in blood and in the case of increase up to 7-9 mmol/l – 2 units of novorapid, up to 10-11 mmol/l – 4 units of novorapid, up 12-13 mmol/l – 6 units of novorapid, up to 14 mmol/l and higher – 8 units of novoropid must be introduced to the patient. It should be noted that it is necessary to inform and explain to the with diabetes patient about the nature of their disease and the need to follow a diet.