Kane P B, Torretti J
Can J Anaesth. 1987 Jul;34(4):380-2. doi: 10.1007/BF03010138.
An 87-year-old female, with a history of hypertension controlled with hydrochlorothiazide, was scheduled for excision of a cystic mass of the left lobe of the thyroid. In the course of the anaesthetic, she developed partial airway obstruction that resulted in respiratory acidosis (PaCO2 108 mmHg, pH 7.06), developed premature ventricular contractions and experienced a reduction in plasma potassium concentration from 3.9 to 2.9 mmole X L-1. We interpret this hypokalaemia as a consequence of the epinephrine discharge due to hypercapnia. The case is reported to emphasize the importance of minimizing the sympathetic response to induction of anaesthesia, intubation and surgery in patients with marginal potassium stores.
一名87岁女性，有高血压病史，服用氢氯噻嗪后病情得到控制，计划接受左叶甲状腺囊性肿物切除术。在麻醉过程中，她出现了部分气道梗阻，导致呼吸性酸中毒（动脉血二氧化碳分压108 mmHg，pH值7.06），出现室性早搏，血浆钾浓度从3.9 mmol/L降至2.9 mmol/L。我们认为这种低钾血症是高碳酸血症引起肾上腺素释放的结果。报告该病例是为了强调对于钾储备处于临界状态的患者，尽量减少麻醉诱导、插管和手术引起的交感反应的重要性。
