Ventricular Dysrhythmia and Unstable Hemodynamics during an Emergency Subdural Hemorrhage Operation in a Chronic Alcoholic Patient: Anesthetic Management of Hypokalemia and Metabolic Alkalosis

We report the anesthetic management of ventricular dysrhythmia and unstable hemodynamics in a chronic alcoholic patient with hypokalemia during an emergency subdural hemorrhage operation. We discuss the pathophysiology, clinical presentation, and possible causes of hypokalemia. Chronic alcoholism, head injury, or metabolic alkalosis might have caused hypokalemia in our patient. Methods to manage hypokalemia, namely monitoring, drug administration, and ventilation strategies, are also reviewed and discussed.

關鍵字

Hypokalemia ； Intentional hypoventilation

並列摘要

此篇案例討論描述一位長期酗酒，因酒後跌倒導致急性硬腦膜下出血而接受緊急手術之病人。此病人於術中血鉀偏低，因而發生短期心室心搏過速，且因此產生不穩定的血行動力學。我們針對此案例討論及查閱相關文獻，推測導致低血鉀的原因分別可能為長期酗酒、頭部外傷以及代謝性鹼中毒，另外，我們也進一步根據其病因討論麻醉上相關的處置方式，包含術前的評估與預防性治療、術中的監測方針、及緊急處理上如何利用藥物及呼吸器的設定來迅速改善病人的血行動力學等等。

並列關鍵字

低血鉀；刻意性低換氣策略

國際替代計量

Ventricular Dysrhythmia and Unstable Hemodynamics during an Emergency Subdural Hemorrhage Operation in a Chronic Alcoholic Patient: Anesthetic Management of Hypokalemia and Metabolic Alkalosis

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