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

Anesth Analg. 2022 Jan 1;134(1):82-89. doi: 10.1213/ANE.0000000000005344.

Abstract

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 29 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.

Publication types

  • Review

MeSH terms

  • Anesthesia / adverse effects
  • Anesthetics / adverse effects*
  • Dexmedetomidine / adverse effects
  • Diabetes Insipidus / etiology*
  • Electrolytes
  • Humans
  • Hypovolemia / etiology
  • Incidence
  • Ketamine / adverse effects
  • Perioperative Period
  • Propofol / adverse effects
  • Retrospective Studies
  • Sevoflurane / adverse effects

Substances

  • Anesthetics
  • Electrolytes
  • Sevoflurane
  • Dexmedetomidine
  • Ketamine
  • Propofol