Korean J Anesthesiol.  2011 Dec;61(6):519-523. 10.4097/kjae.2011.61.6.519.

Hypocalcemia and hypokalemia due to hyperventilation syndrome in spinal anesthesia: A case report

• Moon HS
• Lee SK
• Chung JH
• In CB

• KMID: 1854068
• DOI: http://doi.org/10.4097/kjae.2011.61.6.519

Abstract

Hyperventilation syndrome (HVS) often occurs under stressful conditions, and has been reported during or after anesthesia and operation. HVS, characterized by multiple somatic symptoms and electrolyte imbalances induced by inappropriate hyperventilation, should be managed as an emergency. We report a rare case of HVS during spinal anesthesia. The patient was a previously healthy 51-year-old female without psychogenic conditions. During spinal anesthesia for lower extremity surgery, the patient complained of nausea, headache, paresthesia in the upper extremities and perioral numbness. We found carpal spasm in both hands and flattening of T wave on electrocardiogram (ECG). Emergent arterial blood gas analysis (ABGA) revealed markedly decreased PaCO2, hypocalcemia and hypokalemia. We managed the patient with verbal sedation, electrolytes replacement therapy and closed mask inhalation. HVS subsided gradually. We conclude that monitoring for possible HVS during anesthesia is very important for patient safety.

Keyword

Hyperventilation; Hypocalcemia; Hypokalemia

MeSH Terms

Anesthesia
Anesthesia, Spinal
Blood Gas Analysis
Electrocardiography
Electrolytes
Emergencies
Female
Hand
Headache
Humans
Hyperventilation
Hypesthesia
Hypocalcemia
Hypokalemia
Inhalation
Lower Extremity
Masks
Middle Aged
Nausea
Paresthesia
Patient Safety
Spasm
Upper Extremity
Electrolytes