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Management of postoperative pain in patients with diabetes mellitus


Diabetes mellitus is a major public health concern with a growing prevalence.

There is limited information which is specific to management of postoperative pain in diabetic patients within the sources used by the EKL.

Evidence based recommendations specific to the condition:

Patients with diabetes mellitus may have renal insufficiency as a comorbidity. This should be assessed and analgesics, particularly NSAIDs given accordingly.

Epidural anaesthesia/analgesia may reduce insulin resistance in comparison to general anaesthesia/systemic analgesia in patients who were insulin resistant preoperatively ANZCA chapter 7.2.1, p 182.

Summary

There is little information related specifically to patients with diabetes mellitus within the sources of the EKL. Postoperative pain management of these patients should take into account that these patients may have renal comorbidities.

Supplementary reading

  1. Ducic I, Felder JM 3rd, Iorio ML. The role of peripheral nerve surgery in diabetic limb salvage. Plast Reconstr Surg. 2011 Jan;127 Suppl 1:259S-269S.
  2. Gronwald C, Vowinkel T, Hahnenkamp K. Regional anesthetic procedures in immunosuppressed patients: risk of infection. Curr Opin Anaesthesiol. 2011 Dec;24(6):698-704.
  3. Steele KE, Prokopowicz GP, Chang HY et al Risk of complications after bariatric surgery among individuals with and without type 2 diabetes mellitus. Surg Obes Relat Dis. 2012 May-Jun;8(3):305-30.