The recommendations for withdrawal of Metformin table in the original
article is deceptive. It is clearly incorrect to quote information from
2008 NICE guidelines along with that from an Editorial in 2003. The
advice to withdraw metformin 2 days before general anaesthesia is from the
editorial by Jones and had no evidence to back it up.
Furthermore (and as rapid responders pointed out in 2003), it is not
anaesthesia that is a factor in the development of lactic acidosis but
surgery itself. It is my practice to withdraw Metformin only on the night
prior to surgery and this is standard practice in departments I have
worked in recently.
It is disappointing that inacuracies get reprinted in this way.
Rapid Response:
Metformin and General Anaesthesia
The recommendations for withdrawal of Metformin table in the original article is deceptive. It is clearly incorrect to quote information from 2008 NICE guidelines along with that from an Editorial in 2003. The advice to withdraw metformin 2 days before general anaesthesia is from the editorial by Jones and had no evidence to back it up.
Furthermore (and as rapid responders pointed out in 2003), it is not anaesthesia that is a factor in the development of lactic acidosis but surgery itself. It is my practice to withdraw Metformin only on the night prior to surgery and this is standard practice in departments I have worked in recently.
It is disappointing that inacuracies get reprinted in this way.
Competing interests: None declared
Competing interests: