ArticleCureus2022
Severe Hypokalemia and Metabolic Alkalosis Caused by Licorice Discovered During the Treatment of Intraoperative Hypoxemia.
Article in Cureus, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Article
- Knowledge levels of doctors and nurses working in surgical clinics about nutrients and food supplements, a multicentre descriptive study.BMC nursing · 2024Article
- Liquorice Toxicity: A Comprehensive Narrative Review.Nutrients · 2023Review
- Torsade de pointes during an oral surgery caused by a combination of herbal medicine-induced pseudoaldosteronism and trigeminocardiac reflex.Oxford medical case reports · 2023Article
- Case report: Severe respiratory failure caused by licorice.Frontiers in pharmacology · 2023Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
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.
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