Hyperkalemia/Hypokalemia

Disorders of potassium regulation (hyperkalemia/hypokalemia) are common in clinical medicine. Patients with neuromuscular disorders may develop hyperkalemia in response to inhaled, halogenated anesthetics and/or succinylcholine. This is most likely to occur in patients with occult myopathies. Potassium abnormalities have a wide range of potential implications for patient outcome. For instance, acute hyperkalemia has profound effects on the cardiac action potential that can lead to life-threatening dysrhythmias. In contrast is chronic hypokalemia, which occurs in 10% to 40% of patients receiving thiazide diuretics. In most cases, chronic hypokalemia does not cause perioperative complications unless intraoperative management alters potassium balance. In this chapter we present two clinical case scenarios which center around the underlying processes, detection, and treatment of each of these disorders.