Intraoperative bradycardia and postoperative hyperkalemia in patients undergoing endoscopic third ventriculostomy

B. Anandh, K. R. Madhusudari Reddy, Aaron Mohanty, G. S. Umamaheswara Rao, B. A. Chandramouli

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

During our initial experience with endoscopic third ventriculostomies, we observed intraoperative bradycardia and postoperative hyperkalemia. The present study was carried out to verify the consistency of these initial observations. Intraoperative heart rate (HR) changes and postoperative serum K+ changes were studied prospectively in 20 patients of endoscopic third ventriculostomy. Another 6 patients who underwent endoscopic procedures other than ventriculostomy acted as controls. The anaesthetic technique and intraoperative and postoperative fluid regimen were similar in all patients. Serum K+ concentrations were measured intraoperatively and once a day for the next 5 days. The third ventriculostomy group exhibited a significant slowing of the heart rate during the fenestration of the floor of the third ventricle (112 ± 26 to 101 ± 28 bpm, p < 0.001) and also at the time of the reversal of the neuromuscular block at the end of surgery (104 ± 29 to 96 ± 33 bpm, p < 0.01). The control group did not exhibit similar changes in the heart rate. The postoperative increase in serum K+ values in the ventriculostomy group (0.82 ± 0.55 mmol/L) was higher than that in the control group (0.10 ± 0.44 mmol/L) (p < 0.01). Endoscopic third ventriculostomy is associated with a significant bradycardia at the time of fenestration and at the time of reversal of the neuromuscular block. The procedure is also associated with a postoperative increase in serum K+ values. We propose a mechanism involving distortion of the posterior hypothalamus, which accounts for the bradycardia and postoperative hyperkalemia.

Original languageEnglish (US)
Pages (from-to)154-157
Number of pages4
JournalMinimally Invasive Neurosurgery
Volume45
Issue number3
DOIs
StatePublished - Sep 2002
Externally publishedYes

Fingerprint

Ventriculostomy
Hyperkalemia
Bradycardia
Neuromuscular Blockade
Heart Rate
Serum
Posterior Hypothalamus
Control Groups
Third Ventricle
Anesthetics

Keywords

  • Bradycardia
  • Endoscopy
  • Hyperkalemia
  • Ventriculostomy

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Intraoperative bradycardia and postoperative hyperkalemia in patients undergoing endoscopic third ventriculostomy. / Anandh, B.; Madhusudari Reddy, K. R.; Mohanty, Aaron; Umamaheswara Rao, G. S.; Chandramouli, B. A.

In: Minimally Invasive Neurosurgery, Vol. 45, No. 3, 09.2002, p. 154-157.

Research output: Contribution to journalArticle

Anandh, B. ; Madhusudari Reddy, K. R. ; Mohanty, Aaron ; Umamaheswara Rao, G. S. ; Chandramouli, B. A. / Intraoperative bradycardia and postoperative hyperkalemia in patients undergoing endoscopic third ventriculostomy. In: Minimally Invasive Neurosurgery. 2002 ; Vol. 45, No. 3. pp. 154-157.
@article{d0808a72e8b14553978253765f2c70d6,
title = "Intraoperative bradycardia and postoperative hyperkalemia in patients undergoing endoscopic third ventriculostomy",
abstract = "During our initial experience with endoscopic third ventriculostomies, we observed intraoperative bradycardia and postoperative hyperkalemia. The present study was carried out to verify the consistency of these initial observations. Intraoperative heart rate (HR) changes and postoperative serum K+ changes were studied prospectively in 20 patients of endoscopic third ventriculostomy. Another 6 patients who underwent endoscopic procedures other than ventriculostomy acted as controls. The anaesthetic technique and intraoperative and postoperative fluid regimen were similar in all patients. Serum K+ concentrations were measured intraoperatively and once a day for the next 5 days. The third ventriculostomy group exhibited a significant slowing of the heart rate during the fenestration of the floor of the third ventricle (112 ± 26 to 101 ± 28 bpm, p < 0.001) and also at the time of the reversal of the neuromuscular block at the end of surgery (104 ± 29 to 96 ± 33 bpm, p < 0.01). The control group did not exhibit similar changes in the heart rate. The postoperative increase in serum K+ values in the ventriculostomy group (0.82 ± 0.55 mmol/L) was higher than that in the control group (0.10 ± 0.44 mmol/L) (p < 0.01). Endoscopic third ventriculostomy is associated with a significant bradycardia at the time of fenestration and at the time of reversal of the neuromuscular block. The procedure is also associated with a postoperative increase in serum K+ values. We propose a mechanism involving distortion of the posterior hypothalamus, which accounts for the bradycardia and postoperative hyperkalemia.",
keywords = "Bradycardia, Endoscopy, Hyperkalemia, Ventriculostomy",
author = "B. Anandh and {Madhusudari Reddy}, {K. R.} and Aaron Mohanty and {Umamaheswara Rao}, {G. S.} and Chandramouli, {B. A.}",
year = "2002",
month = "9",
doi = "10.1055/s-2002-34339",
language = "English (US)",
volume = "45",
pages = "154--157",
journal = "Minimally Invasive Neurosurgery",
issn = "0946-7211",
publisher = "Georg Thieme Verlag",
number = "3",

}

TY - JOUR

T1 - Intraoperative bradycardia and postoperative hyperkalemia in patients undergoing endoscopic third ventriculostomy

AU - Anandh, B.

AU - Madhusudari Reddy, K. R.

AU - Mohanty, Aaron

AU - Umamaheswara Rao, G. S.

AU - Chandramouli, B. A.

PY - 2002/9

Y1 - 2002/9

N2 - During our initial experience with endoscopic third ventriculostomies, we observed intraoperative bradycardia and postoperative hyperkalemia. The present study was carried out to verify the consistency of these initial observations. Intraoperative heart rate (HR) changes and postoperative serum K+ changes were studied prospectively in 20 patients of endoscopic third ventriculostomy. Another 6 patients who underwent endoscopic procedures other than ventriculostomy acted as controls. The anaesthetic technique and intraoperative and postoperative fluid regimen were similar in all patients. Serum K+ concentrations were measured intraoperatively and once a day for the next 5 days. The third ventriculostomy group exhibited a significant slowing of the heart rate during the fenestration of the floor of the third ventricle (112 ± 26 to 101 ± 28 bpm, p < 0.001) and also at the time of the reversal of the neuromuscular block at the end of surgery (104 ± 29 to 96 ± 33 bpm, p < 0.01). The control group did not exhibit similar changes in the heart rate. The postoperative increase in serum K+ values in the ventriculostomy group (0.82 ± 0.55 mmol/L) was higher than that in the control group (0.10 ± 0.44 mmol/L) (p < 0.01). Endoscopic third ventriculostomy is associated with a significant bradycardia at the time of fenestration and at the time of reversal of the neuromuscular block. The procedure is also associated with a postoperative increase in serum K+ values. We propose a mechanism involving distortion of the posterior hypothalamus, which accounts for the bradycardia and postoperative hyperkalemia.

AB - During our initial experience with endoscopic third ventriculostomies, we observed intraoperative bradycardia and postoperative hyperkalemia. The present study was carried out to verify the consistency of these initial observations. Intraoperative heart rate (HR) changes and postoperative serum K+ changes were studied prospectively in 20 patients of endoscopic third ventriculostomy. Another 6 patients who underwent endoscopic procedures other than ventriculostomy acted as controls. The anaesthetic technique and intraoperative and postoperative fluid regimen were similar in all patients. Serum K+ concentrations were measured intraoperatively and once a day for the next 5 days. The third ventriculostomy group exhibited a significant slowing of the heart rate during the fenestration of the floor of the third ventricle (112 ± 26 to 101 ± 28 bpm, p < 0.001) and also at the time of the reversal of the neuromuscular block at the end of surgery (104 ± 29 to 96 ± 33 bpm, p < 0.01). The control group did not exhibit similar changes in the heart rate. The postoperative increase in serum K+ values in the ventriculostomy group (0.82 ± 0.55 mmol/L) was higher than that in the control group (0.10 ± 0.44 mmol/L) (p < 0.01). Endoscopic third ventriculostomy is associated with a significant bradycardia at the time of fenestration and at the time of reversal of the neuromuscular block. The procedure is also associated with a postoperative increase in serum K+ values. We propose a mechanism involving distortion of the posterior hypothalamus, which accounts for the bradycardia and postoperative hyperkalemia.

KW - Bradycardia

KW - Endoscopy

KW - Hyperkalemia

KW - Ventriculostomy

UR - http://www.scopus.com/inward/record.url?scp=0036747191&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036747191&partnerID=8YFLogxK

U2 - 10.1055/s-2002-34339

DO - 10.1055/s-2002-34339

M3 - Article

VL - 45

SP - 154

EP - 157

JO - Minimally Invasive Neurosurgery

JF - Minimally Invasive Neurosurgery

SN - 0946-7211

IS - 3

ER -