Perioperative Management of Endocrine and Urologic Medications

A multidisciplinary group has published recommendations on which drugs to continue and which to hold before surgery.

Sponsoring Organization: Society for Perioperative Assessment and Quality Improvement (SPAQI)

Background

SPAQI is a multidisciplinary organization that recently has published several position papers on perioperative medication management. This statement — addressing endocrine and urologic medications — was produced by a consensus process outlined by the authors.

Key Recommendations

Diabetes drugs:

Basal (intermediate- or long-acting) insulins generally should be continued at 60% to 80% of the usual dose on the morning of surgery or the evening before surgery, depending on the patient's usual insulin schedule.
Metformin, sulfonylureas, pioglitazone, and dipeptidyl peptidase (DPP)-4 inhibitors should not be given the morning of surgery.
Sodium–gluco…

Reviewing Author

Allan S. Brett, MD

Disclosures

Nothing to disclose