When an elective surgical patient has been planned for colon surgery, many things would come up for the preparation process. Begin with bowel preparation either an enema or induced with luxatives, oral intake from solid food to clear liquid diet, both procedures can be performed on the day before surgery and can induce a chain reaction by making your patient to dehydration, fatigue, and disturbances in electrolytes. Some medical centres especially in northern europe have abandoned the bowel preparation, but in our hospital it is still working and included in the procedure required for colonic procedure.
Yesterday we encountered an elective colonic patient with a plan for laparoscopic assisted procedure, after an w opioid premedication, an induction agent, and an intubating dose of non-depolarising muscle relaxant were given, a pulse oximetry had showed an unstable wave form showing low output state, then the ECG monitoring showed the atrial fibrillation with the ventricular response of 160/min, so the emergency cart was called, the trachea was intubated at that point the blood pressure was 70/50 mmHg. After the patient was stabilised, a discussion with the surgeon was performed, the conclusion was to call off the surgery. An arterial sample had shown the potassium level of 2.8.
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