J Acute Care Surg.  2020 Nov;10(3):123-125. 10.17479/jacs.2020.10.3.123.

Perioperative Management of a Patient with Hypokalemic Periodic Paralysis: A Case Report

• Bae SI
• Hwang Y
• Kim J
• Tak S
• Sohn JT

• KMID: 2512851
• DOI: http://doi.org/10.17479/jacs.2020.10.3.123

Abstract

Potassium imbalances can be life-threatening and must be identified and corrected prior to surgery. Patients with hypokalemic periodic paralysis (hypoKPP) experience recurrent muscle weakness or paralysis due to hypokalemia. We present the management of a rare case of hypoKPP during surgery and discuss the general complications and perioperative management of the condition. A 70-year-old man with hypoKPP visited the emergency room with abdominal pain requiring a cholecystectomy. He had not experienced hypoKPP since 1993, 1 year after diagnosis. Preoperative examinations were normal, with a serum potassium level of 4.5 mEq/L. Surgery and recovery were uneventful, with potassium levels ≥ 3.3 mEq/L. The post-surgery serum potassium level was 4.3 mEq/L. The patient had no signs of hypokalemia until 1-week post-surgery. Thorough preoperative preparation, careful assessment of serum potassium levels, avoidance of triggering factors, and appropriate postoperative pain relief can help prevent a hypokalemic attack in patients with hypoKPP.

Keyword

hypokalemic periodic paralysis; perioperative care; potassium