Abstract
The anesthetic management of 57 acute alcohol intoxicated patients was reported. The mean blood alcohol level soon after admission was 147mg/dl (34∼344mg/dl). It is important to remember that alcoholic intoxication can mask silent traumatic injuries, and to this end it is imperative to exclude any head or spinal cord injuries. Additionaly, in many cases it is difficult to obtain correct preoperative assessment because intoxicat-ed patients are not cooperative.
The anesthetic management of an acute intoxicated patient is not without its problems because of the general effects of alcohol on the body as a whole. Alcohol causes respiratory depression containing reduced cough and gag reflex, and a metabolic acidosis. This last condition would be compensated for by hyperventilation. A wide-spread cutaneous vasodilation renders intoxicated patients more susceptible to hypoten-sion and hypothermia. An inhibitory effect by alcohol on intestinal glucose absorption induces hypoglycemia even after a short period of fasting. The secretion of antidiuretic hormone is inhibited after acute alcoholic intoxication, resulting in free-water diuresis. At last, the possibility of alcohol withdrawal symptoms in delirium tremens should be remembered. There is a real need for prolonged post-operative supervision of the patient.
