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.