Anesth Pain Med.  2010 Apr;5(2):162-165.

Anesthetic management for child with idiopathic ketotic hypoglycemia: A case report

• Woo SJ
• Kim SH
• Chung MH
• Choi YR

Abstract

Idiopathic ketotic hypoglycemia (IKH) is the common cause of clinically significant non-diabetic hypoglycemia among children. The cause of IKH is decrease in endogenous glucose production after a prolonged fasting. We report the experience of perioperative management for a six-year-old female child undergoing strabismus surgery with a history of IKH. This patient experienced two episodes of severe hypoglycemia and loss of consciousness caused by prolonged fasting at the age of 31 and 41 months. For elective general anesthesia, children should be restricted from fluid and foods to prevent pulmonary aspiration. Because of higher metabolic rate and larger body surface area-to-weight ratio than adult, pediatric patient are more prone to hypovolemia and hypoglycemia during preoperative fasting period. When the preoperative fasting is inevitable in the child with IKH, anesthesiologist should start the parenteral infusion with dextrose-containing fluid and periodically check blood glucose level during perioperative period.

Keyword

Glucose replacement; Ketotic hypoglycemia; Preoperative fasting

MeSH Terms

Adult
Anesthesia, General
Blood Glucose
Child
Fasting
Female
Glucose
Humans
Hypoglycemia
Hypovolemia
Infusions, Parenteral
Perioperative Period
Strabismus
Unconsciousness
Blood Glucose
Glucose