Ambulatory ophthalmological surgical program for insulin-dependent diabetic patients

Abstract

Objective: Insulin-dependent diabetic patients scheduled for vitrectomy, under regional anesthesia were studied during the perioperative period in the ambulatory unit, with the aim of including these patients in our ambulatory surgery program. Materials and Methods: The patients underwent surgery early in the morning without having breakfast or their morning insulin dose. Following a continuous infusion of glucose 10% retrobulbar anesthesia was administered and vitrectomy performed. After surgery, breakfast was given in the recovery area and was followed by the recommended insulin dose. Results: Three men and nine women, ASA 2-3, with the median age of 66 were observed. Blood glucose levels were shown to be between 123 and 337 mg/dl. The insulin dose was individualized for each patient. The average stay in the recovery room was 138 min. One patient was nauseous, none were readmitted. No significant recorded parameter differences were found between these patients and non diabetic patients undergoing ambulatory ophthalmological surgery. Conclusions: Ophthalmological surgery for insulin-dependent diabetic patients, under retrobulbar anesthesia can be performed in an ambulatory setting.