Chronic Hypokalemia and Intraoperative Dysrhythmias

Anesthetic management of a patient with Bartter′s syndrome undergoing bilateral sagittal split osteotomy

“…Since patients with Bartter's syndrome have low serum potassium, hyperventilation should be avoided, as hypocapnia increases blood pH and lowers serum potassium. [14] The effect of neuromuscular-blocking drugs during anesthesia should also be monitored with a nerve stimulator in patients with hypokalemia. The renal function of patients with Bartter's syndrome may affect the choice of the anesthetic agents.…”

The effect of patient-controlled intravenous analgesia on postoperative hypokalemia in patients undergoing laparoscopic cholecystectomy

“…Shah et al [22] showed that hypokalemia was one of the individual factors that was useful in predicting the outcome of perioperative myocardial infarction or cardiac death in patients with cardiac Table 3 Comparison of clinical features at each time point Variables Group T1 T2 T3 T4 T5 T6 Incidence of arrhythmia a IV-PCA 1 -2 1 2 -Control 2 -3 3 2 -VAS score IV-PCA --3 [23] reported that frequent and complex ventricular arrhythmias were common in those with a history of longterm digoxin therapy or congestive heart failure, but hypokalemia did not increase the incidence or severity of ventricular ectopy. Vitez et al [24] reported that the occurrence of intraoperative arrhythmia was not related to chronic hypokalemia but to preexisting preoperative arrhythmia. They reported that the only risk factor for malignant arrhythmias intraoperatively was the presence of cardiovascular disease with concurrent digoxin therapy.…”

Epinephrine, potassium and the electrocardiogram during regional anaesthesia

“…The clinical importance of chronic hypokalaemia for arrhythmias is controversial, however. The current view is that such a relation is more likely to exist when hypokalaemia is acute, particularly when combined with certain health status factors such as acute myocardial infarction and drugs such as digitalis[14].…”