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Anesth Analg 2005;101:986-999
© 2005 International Anesthesia Research Society
doi: 10.1213/01.ane.0000167726.87731.af

PEDIATRIC ANESTHESIA

Perioperative Management of Pediatric Surgical Patients with Diabetes Mellitus

Erinn T. Rhodes, MD, MPH*{ddagger}, Lynne R. Ferrari, MD{dagger}§, and Joseph I. Wolfsdorf, MB, BCh*{ddagger}

*Division of Endocrinology and {dagger}Department of Anesthesiology, Perioperative, and Pain Medicine, Children’s Hospital Boston; {ddagger}Departments of Pediatrics and §Anesthesia, Harvard Medical School, Boston, Massachusetts

Address correspondence and reprint requests to Lynne R. Ferrari, MD, Department of Anesthesiology, Perioperative and Pain Medicine, Children’s Hospital Boston, 300 Longwood Ave., Boston, MA 02115. Address e-mail to Lynne.Ferrari{at}childrens.harvard.edu.

Pediatric patients with diabetes are managed with increasingly complex regimens. To optimally manage these patients during the perioperative period, pediatric anesthesiologists must carefully consider the pathophysiology of the disease, patient-specific methods of treatment, status of glycemic control, and the type of surgery proposed. Important pediatric issues, including body size, pubertal development, and ability to tolerate nil per os status, must be considered. To keep pace with the array of options for treating diabetes in children, the perioperative plan should be developed in consultation with a pediatric endocrinologist. We present an algorithm that was developed at Children’s Hospital Boston for the management of pediatric patients with either type 1 or type 2 diabetes mellitus presenting for surgery and general anesthesia. This collaborative effort between the pediatric anesthesia and endocrine services represents one example of a standardized approach to these patients that should facilitate care and improve management. Differences from previously published recommendations are highlighted, as are expected changes caused by the continued evolution of pediatric diabetes care.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2005 by the International Anesthesia Research Society.