Low SpO2 and myocardial ischemia within two days after operation in diabetic neuropathy patient.

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It is well known that patients with diabetes are associated with significant rates of diabetic neuropathy. Recently asymptomalic myocardial ischemia induced by diabetic neuropathy is going to be a problem.Six nondiabetic patients (control group) and 10 diabetic patients (diabetic group) were scheduled to receive general anesthesia participated in this study. Three standard noninvasive autonomic tests (heart rate variation during deep period breathing, Valsalva maneuver and head-up tilt) were performed in each patient at operating theater before anesthesia. Patients with autonomic dysfunction by autonomic tests were categorized as diabetic autonomic dysfunction group (DM-AD (+) group) and they were undergoing to check holter-ECG and arterial oxygen saturation (SpO2) after 48 hours after surgery. Spectral characteristics of heart rate variability was investigated by holter-ECG.(Results) There are no patients with low SpO2 or myocardial ischemia (ST depression) in this study. But one patient of DM-AD (+) group (n=4) showed negative T wave at least temporarily. There were no significant change of HF value and LF/HF ratio in this study. HF value on postoperative days (POD) two was larger than that of POD 1 (70.8±63.6 v.s. 54.3±46.0ms^2) at control group, but relatively there was no change in DM-AD (+) group. LF/HF ratio on POD2 was smaller than that of POD1 (2.34±1.02 v.s. 3.26±1.78) at control group, but relatively there was no change in DM-AD (+) group.