Management of hypokalemic periodic paralysis in pregnancy: Anaesthetic considerations for a 34-week gestation patient

• Author Details:   
• Pon Sushma
• Karthik Krishnamoorthy ^*

---

View PDF

Hypokalemic periodic paralysis (HypoPP) is a rare autosomal disorder characterized by episodic hypokalemia leading to acute muscle weakness, precipitated by various factors like physical exertion, infection, pregnancy, carbohydrate overload and thyroid abnormalities. We present a successful anesthetic management of a parturient who underwent emergency cesarean section with a diagnosis of HypoPP complicated with premature rupture of membranes. Ensuring the health and safety of both the mother and fetus requires meticulous anesthetic planning during delivery to optimize outcome as it is complicated due to the condition's impact on the motor system, cardiac function and potential respiratory involvement. Emergency cesarean section was planned as the patient was not progressing, remote risk of infection with increase in time, and for pain relief also as stress can surge catecholamine release worsening hypokalemia. Regional anaesthesia was preferred being a cesarean section eliminating the need for neuromuscular blockade which may further worsen her weakness.