Hypokalemia of various etiologies complicating elective surgical procedures

During a 12-month period, 7933 surgical procedures were performed in a suburban intercommunity hospital. Thirty scheduled procedures were cancelled preoperatively by the anesthesia department because the level of serum potassium was below 3.2 mEq/L. Hypokalemia compromised three patients intraoperatively, and two patients suffered severe and life-threatening complications postoperatively. A preoperative bowel preparation produced severe hypokalemia in one patient, thus bringing the routine use of this time-honored procedure into question. The suggestion is made that all patients who are over 50 years of age, and who are scheduled for elective operation, receive an admission evaluation of the level of serum potassium.