By J. D. Michenfelder M.D. (auth.), Theodore H. Stanley MD, W. Clayton Petty MD (eds.)
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Extra info for New Anesthetic Agents, Devices and Monitoring Techniques: Annual Utah Postgraduate Course in Anesthesiology 1983
Diabetes Care 3:77, 1980. Schwartz HC, et al: Effects of pregnancy on hemoglobin Al in normal, gestational diabetic and diabetic woffien. Diabetes 25:1118, 1976. Lucas A, et al: Iatrogenic hyperinsulinism at birth. Lancet 1:44, 1980. Light IJ, Kennan WJ, Sutherland JM: Maternal intravenous glucose administration as a cause of hypoglycemia in the infant of the diabetic mother. Am J Obstet Gynecol 113:345, 1972. ): Anesthesia and Uncommon Diseases. Chap. 3. Diabetes mellitus management of the surgical patient.
We also routinely use barbiturate therapy in these patients during the period of the actual anastomosis. Since the surgeon must temporarily occlude the branch of the middle cerebral artery to which the superficial temporal artery is being anastomosed, we assume that an unknown degree of ischemia to the area of brain supplied by that branch may occur. Therefore before surgical occlusion of the branch of the middle cerebral artery, a "sleep" dose of thiopental (3-5 mg/kg) is administered. Repeat doses are not given during the period of anastomosis since presumably if the area is ischemic we could not deliver further thiopental to it.
Anesthesiology 51:S302, 1979. Lind T, et al: Insulin disappearance rate in pregnant and non-pregnant women and in non-pregnant women given GHRIH. Eur J Clin Invest 7:47, 1977. Kenepp NB, Shelley, CW, Juman S: Effects on newborn of hydration with glucose in patients undergoing cesarean section with regional anesthesia. Lancet 1:645, 1980. Datta S, et al: Acid-base status of diabetic mothers and their infants following spinal anesthesia for cesarean section. Anesth Analg 61:662. 1982. Mathru M, et al: Intravenous albumin administration for prevention of spinal hypotension during cesarean section.