METFORMIN: WHEN TO DISCONTINUE IT BEFORE GENERAL ANESTHESIA?

Abstract: Metformin is one of the main medications in the treatment of type 2 diabetes. Despite its widespread use, there are controversies surrounding the continuation of therapy with this drug during the perioperative period, mainly due to the risk of metabolic acidosis. The likelihood of developing metabolic acidosis associated with the use of metformin is very rare, but it increases in patients with impaired kidney function as well as in conditions of hypoperfusion and hypoxia. There are differences between various recommendations regarding the use of metformin during the perioperative period. The widespread use of the drug, coupled with the lack of consistency in recommendations, should encourage efforts to standardise them, particularly for optimal metabolic control of surgical patients.