Anaesthetic management of a parturient with hypokalaemic periodic paralysis for caesarean section: A case report and review of the literature.

IF 1.1 4区 医学 Q3 ANESTHESIOLOGY Anaesthesia and Intensive Care Pub Date : 2024-07-01 Epub Date: 2024-06-16 DOI:10.1177/0310057X231178840
Rachel M Vassiliadis
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Abstract

A 32-year-old multigravida woman, with known familial hypokalaemic periodic paralysis, underwent spinal anaesthesia for an elective lower segment caesarean section. There are several case reports in the literature discussing the optimal anaesthetic technique. In the past there has not been an emphasis on aggressive and early potassium replacement. A target level to commence replacement of potassium at 4.0 mmol/L or less is proposed. Careful preoperative preparation, frequent perioperative monitoring and early potassium replacement resulted in no perioperative episodes of weakness in this case, in contrast with other case reports where potassium was either not monitored or not replaced early enough, resulting in postoperative attacks. Another factor to consider in hypokalaemic periodic paralysis is the avoidance of triggers, including certain medications. Misoprostol was used in this instance to avoid potential electrolyte derangements from other uterotonics.

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剖腹产低钾周期性麻痹产妇的麻醉管理:病例报告和文献综述。
一名 32 岁的多产妇已知患有家族性低钾性周期性麻痹,在选择性下段剖腹产手术中接受了脊髓麻醉。文献中有多篇病例报告讨论了最佳麻醉技术。过去,人们并不重视积极和早期补钾。建议将开始补钾的目标水平定为 4.0 mmol/L 或更低。该病例通过术前精心准备、围术期频繁监测和早期补钾,没有在围术期出现虚弱症状,而其他病例报告中,要么没有监测钾,要么没有及早补钾,导致术后发作。低血钾性周期性麻痹的另一个考虑因素是避免诱发因素,包括某些药物。本例中使用了米索前列醇,以避免其他子宫收缩剂可能引起的电解质紊乱。
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来源期刊
CiteScore
2.70
自引率
13.30%
发文量
150
审稿时长
3 months
期刊介绍: Anaesthesia and Intensive Care is an international journal publishing timely, peer reviewed articles that have educational value and scientific merit for clinicians and researchers associated with anaesthesia, intensive care medicine, and pain medicine.
期刊最新文献
JG Farrell and The Lung: An early description of intensive care delirium in literature. Promoting behavioural change by educating anaesthetists about the environmental impact of inhalational anaesthetic agents: A systematic review. MET call prevention. A cross-sectional study of the relationship between iron deficiency anaemia and chronic pain. Maximising environmental sustainability on the return to in-person conferencing: Report from a 2500-person anaesthesia meeting in Sydney, Australia.
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