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[IPp] Anesthesia -on Pump



 Last July, my daughter had jaw surgery and was under general anesthesia for
five hours. She kept her pump on the whole time. Since she had nothing to eat or
drink after midnight before the surgery, there was no need to bolus--just let
the basals run as normal. I can't remember if we had to correct anything during
the night, but if we did, I'm sure we followed our conservative night correction
ratio, which is 1 to 20, rather than her daytime food bolus of 1-10. Anxiety
about the surgery might make her run a little higher than normal. We watched her
basals rather carefully a couple of weeks prior to the surgery to make sure they
were adjusted to her current needs as close as we could get them. The morning of
the surgery, about 1 hour before, we upped her basal from .8/hr to .9/hr. to be
sure to avoid a chance of a low for the next 8 hrs. She ended up running about
180-250 during surgery, but they didn't seem concerned-wanted her a little high
rather than have the chanc!
  e of a low during surgery. Due to the length of this surgery though, she had
an IV with a 5% glucose drip going and that was not compensated for in her pump
insulin. They were prepared to administer her novolog insulin by syringe if
needed. In the recovery room, she corrected for her 200+ reading herself as they
watched her. She calculated it herself and did it correctly. That night I
gradually adjusted the insulin boluses to bring her count down to 150 and
compensate for the glucose drip. We tested every 2 hours for the first 24 post
surgery. One thing to ask about--what if she goes low during the night before
surgery--what can she have to bring it up? Our Dr. said to give her hard candy
to suck on--she hates glucose tabs. Be sure whatever you give her is ok for the
pre-surgery. Good luck.
Sherry, mom to Liz, 15ys., pumping mm508("the old workhorse") 
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