The Overstated Risk of Preoperative Hypokalemia

Hirsch, Irving A.; Tomlinson, David L.; Slogoff, Stephen; Keats, Arthur S.

doi:10.1097/00132586-198810000-00045

Cited by 26 publications

(5 citation statements)

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“…During the 1980s, there was growing interest in the potential hazards of hypokalaemia during anaesthesia (1)(2)(3)(4)(5). A low serum potassium level increases conductivity, automaticity and excitability of the heart and has been associated with life-threatening ventricular arrhythmias (1,2).…”

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confidence: 99%

Serum potassium levels after induction of epidural anaesthesia using mepivacaine with and without adrenaline

Löfgren¹,

Hahn²

1991

Acta Anaesthesiol Scand

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The short-term effect of epidural anaesthesia (EDA) on the serum potassium (S-K) concentration was studied in 40 elderly men scheduled for minor urological surgery. In Group I, EDA was induced with mepivacaine 2% + adrenaline 1:200,000 (n = 20) and in Group II mepivacaine 2% was used (n = 20). When EDA had been induced, the mean plasma level of adrenaline was tripled in Group I, while it had decreased in Group II. In Group I there was a decrease in the arterial S-K concentration of up to 0.75 mmol.l-1 with a mean of 0.31 mmol.l-1, s.d. 0.20 (P less than 0.001). In Group II, a small but significant decrease of the S-K level was recorded in arterial (0.14 mmol.l-1, s.d. 0.14; P less than 0.001) but not in venous serum. Two-way analysis of variance showed that the addition of adrenaline to the local anaesthetic solution, but not the choice of using arterial or venous serum for analysis, significantly correlated to the lowering of the S-K concentration (P less than 0.001).

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mentioning

confidence: 99%

Serum potassium levels after induction of epidural anaesthesia using mepivacaine with and without adrenaline

Löfgren¹,

Hahn²

1991

Acta Anaesthesiol Scand

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“…Hypokalemia may also lead to cardiac arrythmia, and this situation becomes more noticeable with anesthetic agents such as halothane 10 . However, Hirsch et al 17 determined that arrythmias are associated with the severity of the heart disease and situations such as digoxin treatment but not associated with hypopotassemia presence in the preoperative period or diuretic treatment.…”

Section: Discussionmentioning

confidence: 99%

Preoperative hemogram and biochemistry values of patients undergoing oral and dental surgical operations under local anesthesia

Eğe

Geyik

Kurt

et al. 2020

Cukurova Medical Journal

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The purpose of this study is to investigate the preoperative hemogram and biochemistry values of patients who undergo oral and dental surgical operations under local anesthesia. Materials and Methods: The study included 1598 patients who visited the Faculty of Dentistry at Adıyaman University. The patients' demographic information as age and sex and biochemistry values as blood glucose level (BGL), Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Gama-Glutamyl Transpeptidase (GGT), sodium (Na), potassium (K) and calcium (Ca) and hemogram values as white blood cell count (WBC), Hemoglobin (HGB), Hematocrit (HCT) and Platelet count (PLT) were recorded and statistically analyzed. Results: There were abnormal values outside the normal limits in all hemogram and biochemical values that were examined. Among these, high values of BGL, AST, ALT, GGT and WBC and low values of Na, Ca, HGB and HCT were more frequent. When the values measured outside the reference ranges were examined in terms of sex, it was seen that the GGT values were significantly higher in the men, while the HGB and PLT values were significantly higher in the women. The abnormal values were distributed significantly more among the age group of 21-40. Conclusion: In patients from whom detailed medical anamnesis is not collected, it is believed that taking hemogram and biochemical tests before oral surgical procedures is important in terms of elimination of negative issues that may arise. Amaç: Bu çalışmanın amacı lokal anestezi altında oral cerrahi işlem geçiren hastaların preoperatif hemogram ve biyokimya değerlerinin araştırılmasıdır. Gereç ve Yöntem: Çalışmaya Adıyaman Üniversitesi Diş Hekimliği Fakültesi'ne başvuran 1598 hasta dahil edildi. Hastalara ait yaş, cinsiyet gibi demografik bilgiler ile kan glukoz seviyesi (KGS), Aspartat Aminotransferaz (AST), Alanin Aminotransferaz (ALT), Gama-Glutamil Transpeptidaz (GGT), sodyum (Na), potasyum (K) ve kalsiyum (Ca) gibi biyokimya değerleri ve beyaz küre sayısı (WBC), Hemoglobin (HGB), Hemotaktit (HCT), Trombosit sayısı (PLT) gibi hemogram değerleri kaydedildi ve istatistiksel olarak analiz edildi. Bulgular: İncelenen tüm hemogram ve biyokimyasal değerlerin hepsinde normal sınırların dışında seyreden anormal değerler görüldü. Bunlardan KGS, AST, ALT, GGT, WBC değerlerinde yüksek değerler; Na, Ca, HGB, HCT değerlerinde ise düşük değerler sayıca daha fazla bulundu. Referans aralığının dışında ölçülen anormal değerler cinsiyet bakımından değerlendirildiğinde istatistiksel olarak GGT'nin anlamlı şekilde erkeklerde; HGB ve PLT'nin ise anlamlı şekilde kadınlarda daha fazla sayıda görüldüğü bulundu. Anormal değerlerin yaş grupları bakımından ise istatistiksel olarak anlamlı şeklide 21-40 yaş arasında dağılım gösterdiği görüldü. Sonuç: Detaylı tıbbi anamnez alınamayan hastalarda oral cerrahi işlemler öncesinde hemogram ve biyokimyasal testlerin alınmasının oluşabilecek olumsuz durumların eliminasyonu açısından önem arz ettiğini düşünmekteyiz.

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“…Siscovick et al [21] reported that the addition of a potassium-sparing drug to low-dose thiazide therapy was associated with a reduced risk of cardiac arrest in patients with hypertension. 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.…”

Section: Discussionmentioning

confidence: 99%

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

Lee

Hahm

et al. 2011

J Anesth

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The Overstated Risk of Preoperative Hypokalemia

Cited by 26 publications

References 0 publications

Serum potassium levels after induction of epidural anaesthesia using mepivacaine with and without adrenaline

Serum potassium levels after induction of epidural anaesthesia using mepivacaine with and without adrenaline

Preoperative hemogram and biochemistry values of patients undergoing oral and dental surgical operations under local anesthesia

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

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