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

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 orparalysis due to hypokalemia. We present the management of a rare case of hypoKPP during surgeryand discuss the general complications and perioperative management of the condition. A 70-year-oldman 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 werenormal, with a serum potassium level of 4.5 mEq/L. Surgery and recovery were uneventful, withpotassium levels ≥ 3.3 mEq/L. The post-surgery serum potassium level was 4.3 mEq/L. The patienthad no signs of hypokalemia until 1-week post-surgery. Thorough preoperative preparation, carefulassessment of serum potassium levels, avoidance of triggering factors, and appropriate postoperativepain relief can help prevent a hypokalemic attack in patients with hypoKPP.