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Korean J Anesthesiol > Volume 54(6); 2008 > Article
Korean Journal of Anesthesiology 2008;54(6):694-697.
DOI: https://doi.org/10.4097/kjae.2008.54.6.694   
Refractory Hypotension after Anesthesia Induction in a Patient with Diabetic Autonomic Neuropathy and Chronic Renal Failure: A case report.
Chang Jae Kim, Mee Young Chung, Go Un Jung, Jun Seuk Chea, Byung Ho Lee
Department of Anesthesiology and Pain Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea. jhjs0806@catholic.ac.kr
Abstract
Patients with diabetes or chronic renal failure may develop profound hypotension after anesthesia induction. In a patient with chronic renal failure, inappropriate dialysis may aggravate the hypotension. Combined autonomic neuropathy in diabetes mellitus is the main cause of the undesirable changes in blood pressure after anesthesia induction. We report a case of hypotension refractory to fluid replacement and inotropes in a patient with chronic renal failure for 10 years and diabetes mellitus for 5 years. The patient received hemodialysis on the day before surgery and had developed various symptoms suggestive of autonomic neuropathy (i.e., dizziness on standing, esophageal spasm, intermittent diarrhea).
Key Words: chronic renal failure; diabetic neuropathy; hypotension
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