Anesthetic Considerations for Patients With Hypokalemic Periodic Paralysis Undergoing Ambulatory Surgery: A Case
Ashwini Joshi1, Caroline Andrew, Christine L Mai
1From the Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts.
Abstract:
The perioperative management of patients with hypokalemic periodic paralysis is challenging due to the risk of postoperative muscle weakness. We describe a patient with hypokalemic periodic paralysis who presented for wisdom teeth extraction. Our perioperative goals included minimizing exposure to weakness triggers such as hypokalemia, pain, anxiety, hypothermia, and neuromuscular blockade. The patient tolerated the procedure under deep sedation with intravenous agents, local anesthesia, and a natural airway with spontaneous ventilation. He experienced mild upper extremity weakness postoperatively, which resolved spontaneously. This case report highlights considerations relevant to anesthesia care for patients with hypokalemic periodic paralysis having ambulatory surgeries.
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