Journal article
Severe Hypokalemia and Metabolic Alkalosis Caused by Licorice Discovered During the Treatment of Intraoperative Hypoxemia
Curēus (Palo Alto, CA), Vol.14(5), 25432
05/28/2022
DOI: 10.7759/cureus.25432
PMCID: PMC9236722
PMID: 35774714
Abstract
One of the causes of preoperative hypokalemia is the prolonged use of herbal medicines, especially licorice. Licorice can induce pseudo-aldosteronism, hypertension, metabolic alkalosis, and hypokalemia. An 87-year-old woman with a history of knee osteoarthritis was scheduled to undergo a total knee arthroplasty (TKA) under spinal anesthesia. She had also been prescribed herbal medicine for osteoarthritis of the knee two years before the surgery. During the surgery, the pulse oximeter showed hypoxemia. After the surgery was completed, arterial blood sampling showed hypoxemia, hypokalemia with electrocardiography (ECG) abnormalities, and metabolic alkalosis. The symptoms improved after the discontinuation of herbal medicines and administering potassium chloride. It is necessary to suspect electrolyte abnormalities as one of the causes of hypoxemia, hypertension, or ECG abnormalities in patients prescribed herbal medicines. Therefore, it is also important to ensure that patients on such drugs have their blood potassium levels assessed frequently in the perioperative period.
Details
- Title: Subtitle
- Severe Hypokalemia and Metabolic Alkalosis Caused by Licorice Discovered During the Treatment of Intraoperative Hypoxemia
- Creators
- Taisuke Shibata - Kameda Medical CenterHiromi Yoshinuma - Kameda Medical CenterDaisuke Sugiyama - Kameda Medical CenterOsamu Kobayashi - Kameda Medical Center
- Resource Type
- Journal article
- Publication Details
- Curēus (Palo Alto, CA), Vol.14(5), 25432
- DOI
- 10.7759/cureus.25432
- PMID
- 35774714
- PMCID
- PMC9236722
- NLM abbreviation
- Cureus
- ISSN
- 2168-8184
- eISSN
- 2168-8184
- Publisher
- Cureus
- Language
- English
- Date published
- 05/28/2022
- Academic Unit
- Anesthesia
- Record Identifier
- 9984787235802771
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