Open AccessRegional anesthesia is safe and effective for lower limb orthopedic surgery in patient with renal tubular acidosis and hypokalemia
Author(s) -
Indira Gurajala,
Sapna Annaji Nikhar,
Kavitha Jayaram,
Gurumurthy Ramachandran
Publication year - 2018
Publication title -
journal of anaesthesiology-clinical pharmacology/journal of anaesthesiology clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.466
H-Index - 32
eISSN - 2231-2730
pISSN - 0970-9185
DOI - 10.4103/0970-9185.168203
Subject(s) - medicine , hypokalemia , respiratory acidosis , orthopedic surgery , anesthesia , acidosis , renal tubular acidosis , metabolic acidosis , surgery
Renal tubular acidosis (RTA) with hypokalemia may precipitate acute respiratory failure and potentially fatal arrhythmias like ventricular fibrillation. Though there are random reports of respiratory failure needing mechanical ventilation and sudden death in patients with RTA and hypokalemia, the anesthetic management of these patients has not been clearly elucidated. Acidosis and hypokalemia have significant interactions with both general and local anesthetics and alter their effect substantially. Proper preoperative planning and optimization are required for the safe conduct of anesthesia in this subset of patients. We describe a case of distal RTA, hypokalemia, and metabolic bone disease in whom central neuraxial anesthesia was effectively used for lower limb orthopedic surgery with no complications.