Cardiorespiratory failure and diabetic autonomic neuropathy: a case report
Cánovas, L.; López, R.; Domínguez, M.; Gómez, A.; Ramil, M.; Castro, A.
Revista Espanola de Anestesiologia y Reanimacion 45(9): 397-400
1998
ISSN/ISBN: 0034-9356 PMID: 9847658 Document Number: 486928
Advanced autonomic neuropathy in diabetic patients is associated with homeostatic cardiovascular response. Sympathetic compensation diminishes and the organism becomes more susceptible to the depressant effect of certain drugs. The incidence of undesirable cardiovascular effects (bradycardia, hypotension and sudden heart failure) during anesthesia is higher in such patients. We report the case of a woman with diabetes who suffered two episodes of sudden heart failure after brachial plexus block through the axilla, followed one year later by sudden heart failure during general anesthesia for kidney transplantation. The possible contributing mechanisms are described.