[Anesthetic management of a patient with hyperkalemic tubular acidosis].
We experienced the anesthetic management of a 72-year-old female with hyperkalemia, metabolic acidosis and renal insufficiency, undergoing right total hip replacement for rheumatic arthritis. She had been treated with nonsteroidal anti-inflammatory drugs (NSAIDs) for last several years. Anesthesia was maintained with isoflurane 0.2-1.0% and nitrous oxide in oxygen supplemented with vecuronium. Continuous infusion of prostaglandin E1 0.05-0.10 microgram.kg-1 x min-1 and bolus infusion of 7.0% NaHCO3 during the operation were useful in controlling blood pressure, improving hyperkalemia and maintaining renal function. Postoperatively, she was diagnosed to have hyperkalemic tubular acidosis due to interstitial nephritis induced by NSAIDs.
Kitoh
T
T
Department of Anesthesia, Shinonoi General Hospital, Nagano.
Mizuno
K
K
Nagasawa
M
M
Otagiri
T
T
D000141:Acidosis, Renal Tubular / Q000150:complications*; D000368:Aged; D000758:Anesthesia / Q000379:methods*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000601:surgery*; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D006947:Hyperkalemia / Q000150:complications*