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KMID : 0356920080540060694
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Korean Journal of Anesthesiology
2008 Volume.54 No. 6 p.694 ~ p.697
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Refractory Hypotension after Anesthesia Induction in a Patient with Diabetic Autonomic Neuropathy and Chronic Renal Failure - A case report -
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Kim Chang-Jae
Chung Mee-Young
Jung Go-Eun
Chea Jun-Seuk
Lee Byung-Ho
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Abstract
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Patients with diabetes or chronic renal failure may develop profound hypotension after anesthesia induction. In a patient with chronic renal failure, inappropriate dialysis may aggravate the hypotension. Combined autonomic neuropathy in diabetes mellitus is the main cause of the undesirable changes in blood pressure after anesthesia induction. We report a case of hypotension refractory to fluid replacement and inotropes in a patient with chronic renal failure for 10 years and diabetes mellitus for 5 years. The patient received hemodialysis on the day before surgery and had developed various symptoms suggestive of autonomic neuropathy (i.e., dizziness on standing, esophageal spasm, intermittent diarrhea).
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KEYWORD
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chronic renal failure, diabetic neuropathy, hypotension
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