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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

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