The perioperative management of metformin for the oral and maxillofacial surgery patient: risks and recommendations.

摘要

In 2015 it is estimated that 250 million people will have diabetes mellitus (DM). The growing epidemic of diabetes, particularly among young children, has found its way into the office of the oral and maxillofacial surgeon more than ever before. Metformin (Glu-cophage; Bristol-Myers Squibb, New York, NY) is an oral hypoglycemic often used solely or as an adjunct in the treatment of type 2 diabetes mellitus. The complication of lactic acidosis is indeed uncommon, but with a potentially fatal outcome, its importance cannot be ignored. To date, there has been a paucity in the literature for the perioperative management of metformin. Many surgeons and anesthesiologists are unaware of the potential dangers and how they can be avoided. This article will review the evidence, and we will attempt to put forth guidelines in the management of this commonly used drug in the perioperative period, focusing on the oral and maxillofacial surgeon.