alexa Hypertonic Mannitol-Induced Hyperkalemia during Craniot
ISSN: 2155-6148

Journal of Anesthesia & Clinical Research
Open Access

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Case Report

Hypertonic Mannitol-Induced Hyperkalemia during Craniotomy

Masato Nakasuji*, Masataka Nomura, Miwako Yoshioka, Taeko Miyata, Norie Imanaka, and Masuji Tanaka

Department of Anesthesiology, Kansai Electric Power Hospital, Osaka, Japan

*Corresponding Author:
Masato Nakasuji, MD
Department of Anesthesiology
Kansai Electric Power Hospital
2-1-7 Fukushima, Fukushima-ku
Osaka 553-0003, Japan
Tel: +81-6-6458-5821
Fax: +81-6-6458-6994
E-mail: [email protected]

Received date: February 24, 2013; Accepted date: March 20, 2013; Published date: March 22, 2013

Citation: Nakasuji M, Nomura M, Yoshioka M, Miyata T, Imanaka N, et al. (2013) Hypertonic Mannitol-Induced Hyperkalemia during Craniotomy. J Anesthe Clinic Res 4:299. doi: 10.4172/2155-6148.1000299

Copyright: © 2013 Nakasuji M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



We experienced two cases of mannitol-induced hyperkalemia during craniotomy for ruptured aneurysms. Hyperkalemia was first diagnosed by peaked T wave on the ECG. Serum potassium concentration in each patient was approximately 2 mEq/l higher than the baseline value, reaching 6.0 and 5.7 mEq/l, respectively, at 2 hours after completion of infusion of 45 and 30 g mannitol, respectively. Although the underlying mechanism was not elucidated, we recommend that patients with potassium concentration more than 4 mEq/l before infusion, should undergo repeated arterial blood gases analysis until at least 2 hrs after completion of mannitol infusion.

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