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Chapter: Clinical Anesthesiology: Perioperative & Critical Care Medicine: Acid-Base Management

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Anesthetic Considerations in Patients With Alkalemia

Respiratory alkalosis seems to prolong the duration of opioid-induced respiratory depression; this effect may result from increased protein binding of opioids.

ANESTHETIC CONSIDERATIONS IN PATIENTS WITH ALKALEMIA

 

Respiratory alkalosis seems to prolong the duration of opioid-induced respiratory depression; this effect may result from increased protein binding of opi-oids. Cerebral ischemia can occur from marked reduction in cerebral blood flow during respiratory 10 alkalosis, particularly during hypotension.

 

The combination of alkalemia and hypokale-mia can precipitate severe atrial and ventricular arrhythmias. Potentiation of nondepolarizing neu-romuscular blockade is reported with alkalemia, but may be more directly related to concomitant hypokalemia.

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