Complications in the use of anesthesia in uncontrolled diabetic patients inthe comprehensive clinic of January--December 2024
Keywords:
: diabetes, anesthetic, hyperglycemia, perioperative, clinical protocols.Abstract
Introduction: Anesthetic management in patients with uncontrolled diabetes
represents a challenge due to the increased risk of metabolic, cardiovascular, and
infectious complications. Objective: This study aimed to improve patient safety by
optimizing the use of anesthetics and reducing associated risks. It also promotes a
better understanding of their effects, contributing to safer dental care (American
Diabetes Association, 2024). Data Collection Method: Information was gathered
through searches in databases such as PubMed, SciELO, Google Scholar, and
Elsevier, using terms such as “anesthesia in uncontrolled diabetics” and “anesthetic
complications in diabetes” (Munoz et al., 2022). Development: Between January
and December 2024, 58 patients with uncontrolled diabetes underwent dental
treatment under local anesthesia at the Integral Clinic. The majority were male
(65%), with an average age of 59 years and HbA1c >8% in 72%. Sixty percent did
not have endocrinological follow--up.The most frequent complications were
intraoperative hyperglycemia (30%), postoperative hypoglycemia (12%),
hypotension (15%), arrhythmias (8%), ischemia (5%), surgical infections (18%),
pneumonia (7%), and neurological alterations (6%) due to severe hypoglycemia
(Zhou et al., 2023).Risk factors identified included HbA1c >9%, lack of insulin
adjustment, hypertension, obesity, and surgical duration. Although monitoring and
adjustment protocols were applied, there are still opportunities for improvement
(Kwon et al., 2022). Conclusion: It is essential to establish specific protocols and
adopt a multidisciplinary approach to reduce risks and improve outcomes in these
patients (American Diabetes Association, 2024).
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