Ventricular tachycardia without preceding electrocardiogram change after hypertonic mannitol administration: a case
Akira Gohara1,2, Sumi Okamatsu-Kifuji1, Shinjiro Shono1
1Department of Anesthesiology, Fukuoka University Chikushi Hospital, Chikushino, Japan.
Background:
Mannitol is widely used during neurosurgery, but it has a serious complication including lethal arrhythmia due to mannitol-induced hyperkalemia.
Case Presentation:
We report on a 62-year-old man scheduled for the clipping of an unruptured cerebral artery aneurysm. During surgery, approximately 20 min after the end of 200-mL 20% hypertonic mannitol administration, ventricular tachycardia (VT) occurred without preceding electrocardiogram (ECG) change, such as peaked T waves, and VT was recovered to sinus rhythm after chest compression. A potassium concentration after recovery from VT was 6.4 mEq/L, which was normalized by the administration of calcium gluconate, furosemide, and insulin with glucose.
Conclusions:
Physicians must be aware that VT without preceding ECG change can occur after hypertonic mannitol administration.
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