Why the study?
Does cardiovascular autonomic neuropathy affect peri-operative haemodynamics and cardiovascular complications during anaesthesia?
Does cardiovascular autonomic neuropathy affect peri-operative haemodynamics and cardiovascular complications during anaesthesia?
Pre-operative assessment of cardiovascular autonomic neuropathy in high-risk populations like diabetics may help reduce peri-operative haemodynamic instability and cardiovascular complications.
May support pre-operative autonomic testing in high-risk patients; leaves open whether screening reduces complications in prospective trials.
Cardiovascular autonomic neuropathy is frequently observed in patients with diabetes mellitus. As anaesthesia has a marked effect on peri-operative autonomic function, the interplay between diabetic neuropathy and anaesthesia may result in unexpected haemodynamic instability during surgery. The objective of this literature review was to examine the association of cardiovascular autonomic neuropathy with peri-operative cardiovascular complications. We searched PubMed for articles with search elements of autonomic dysfunction [MeSH] AND anaesthesia [MeSH] AND complications [MeSH]. Depending on the type of anaesthesia, the presence of cardiovascular autonomic neuropathy in surgical patients can markedly affect peri-operative haemodynamics and postoperative recovery. Pre-operative testing of the extent of autonomic dysfunction in particular populations, like diabetics, may contribute to a reduction in haemodynamic instability and cardiovascular complications. Non-invasive diagnostic methods assessing autonomic function may be an important tool during pre-operative risk assessment.
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Lankhorst et al. (2014) studied this question.