Perioperative Diabetes Insipidus Caused by Anesthetic Medications: A Review of the Literature

Lauren M Van Decar, Emily G Reynolds, Emily E Sharpe, Monica W Harbell, Heidi E Kosiorek, Molly B Kraus
Anesthesia and Analgesia 2021 January 6
Diabetes insipidus (DI) is an uncommon perioperative complication that can occur secondary to medications or surgical manipulation and can cause significant hypovolemia and electrolyte abnormalities. We reviewed and evaluated the current literature and identified 24 cases of DI related to medications commonly used in anesthesia such as propofol, dexmedetomidine, sevoflurane, ketamine, and opioids. This review summarizes the case reports and frequency of DI with each medication and presents possible pathophysiology. Medication-induced DI should be included in the differential diagnosis when intraoperative polyuria is identified. Early identification, removal of the agent, and treatment of intraoperative DI are critical to minimize complications.

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