Intervention and measurement
hypoglycemia, pain, diabetes
HYPOGLYCEMIA, DIABETES
Oral antidiabetic medications were continued in diabetes patients on the day before surgery, and were discontinued on the day of surgery. The doses of long-acting insulin administered should be reduced by 50–75% on the night before surgery to avoid hypoglycemia during a prolonged fast. Half doses of basal insulin were administered the morning of surgery [The patient was catheterized on radial artery under local anesthesia before induction, and blood was collected to measure the baseline data of relevant outcomes (blood glucose, insulin, and cortisol levels). Midazolam 0.04 mg/kg, sufentanil 0.4 µg/kg, propofol 2 mg/kg and cis-atracurium 0.2 mg/kg were administered for induction of conventional general anesthesia. Endotracheal intubation was performed after mask-assisted ventilation for 3 min.For patients in the TIHA group, anesthesia was maintained with inhaled desflurane (1.0 to 1.5 minimum alveolar concentrations) and intravenous remifentanil infusion (0.12 to 0.24 µg·kgIntraoperatively monitored parameters included heart rate, invasive blood pressure, pulse oxygen saturation (SPatients controlled analgesia, with a sufentanil infusion pump was used in the first 72 h after surgery. Dezocine were used for pain relief 3 days after the surgery. Postoperative use of hormones, non-steroidal anti-inflammatory drugs were avoided.If the intraoperative glucose level was much higher than 10 mmol/L, an advisable dose of insulin should be given without causing hypoglycemia [