DOI: 10.1097/EJA.0b013e32833f53d1
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PMID: 20842039
Issn Print: 0265-0215
Publication Date: 2011/01/01
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Excerpt
Fluid and electrolyte balance are important considerations during the perioperative care of small children. Fasting guidelines have been developed to minimise the likelihood of dehydration and electrolyte imbalance in the preoperative period. The consequences of undetected perioperative hypoglycaemia are so catastrophic that predisposing factors should be actively sought during the preoperative assessment. A review of glucose management highlighted several areas for caution.1 These include children less than 48 h old,2 children below the third centile for weight3 and children receiving concurrent medical therapy. Propranolol is used to treat a number of conditions in childhood, including paroxysmal supraventricular tachycardia, migraine and hypercyanotic spells in children with Tetralogy of Fallot. Perioperative hypoglycaemia has been previously reported to occur following prolonged fasting in children treated with propranolol.4,5 We report a case of intraoperative hypoglycaemia in a child receiving propranolol for symptomatic management of Tetralogy of Fallot after a short preoperative fast.
