::INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES::

CODEN : IAJPBB
issn 2349-7750

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TITLE:

INTRAOPERATIVE MANAGEMENT OF DIABETES BY ANAESTHETOLOGISTS COMPARED TO INTERNISTS

AUTHORS:

Intessar Sultan, Sameh Said Mohammed, Ayman M H T Elsayed, Angham Tariq Ashi, Alhassan Mashhoor Jalal, Bader Talal Fatani, Deyala Wadie Saadawi, Maisa Sameer Alkabli

ABSTRACT:

BACKGROUND: Surgery in patients with diabetes mellitus (DM) has increased morbidity and mortality. Preoperative management guidelines are extensive starting days before surgery. However’ the main intraoperative task lies on anaesthetologists rather than intenists.OBJECTIVES: to explore knowledge, attitude and practice of physicians towards intraoperative management of DM and to compare between anaesthetologists and internists. METHODS: This cross-sectional study included 100 physicians (57% females & 43 % males) from governmental (73%) and private (27%) hospitals in Jeddah, Saudi Arabia. From August to November 2018, participants received through e-mails a self-answered questionnaire consisting of 13 questions on intra-operative management of DM. Poor practice was decided if right answer was < 60% or total score < 8 (out of 17). RESULTS: participants’ median age was 30.0 (23.0-60.0) years with 5.0 years (1.0-35.0) median period of experience. Their median total score was accepted (8) and was positively associated with duration of experience (r=0.263, p=0.008) but not the professional groups (p=0.447). Anaesthetologists had increased odds of low scores compared to internists (OR 2.62 (95% CI: 1.16-5.92), p=0.011); however, they were equally satisfied by their practice (p=0.402). Their main defects were the duration of fasting (16%), timing of glucose monitoring (44%), indications for postponing surgery (38%), factors guiding management (58%), how to use variable rate insulin infusion (VRII), (52%), when to postpone surgery, (38%) and what guide intraoperative management (58%). CONCLUSION: physicians were satisfied by their KAP concering intraoperative DM management; however, they had many defects. There is a need to improve implementation of recent guidelines especially among anaesthetologists. New guidelines should focus on intraoperative management and to direct thir clear recommendation to the anaethetitis.