Korean J Anesthesiol.  2006 Sep;51(3):391-394. 10.4097/kjae.2006.51.3.391.

Diabetic Ketoacidosis with Severe Hypotension in Epidural Anesthesia: A case report

• Roh WS
• Lee DS
• Lee JS

• KMID: 2237446
• DOI: http://doi.org/10.4097/kjae.2006.51.3.391

Abstract

Morbidity and mortality are higher in diabetics undergoing surgery, which most often reflect various cardiovascular complications. Ketoacidosis is the most serious acute metabolic complications of diabetes perioperatively. Ketoacidosis has adverse effects such as decreased myocardial contractility and peripheral vascular tone, dehydration and electrolyte imbalances. We encountered a case of a 47 year-old man who presented with ketoacidosis and severe hypotension 15 minutes after being administered epidural anesthesia for femoro-popliteal arterial bypass surgery. This case highlights the need for anesthesiologists to consider the possibility that ketoacidosis can mimic severe hypotension due to epidural anesthesia or cardiogenic shock.

Keyword

complication; diabetes mellitus; hypotension; ketoacidosis

MeSH Terms

Anesthesia, Epidural*
Dehydration
Diabetes Mellitus
Diabetic Ketoacidosis*
Humans
Hypotension*
Ketosis
Middle Aged
Mortality
Shock, Cardiogenic