Total intravenous anaesthesia in a patient with familial hypokalaemic periodic paralysis

A 35-year-old woman with known familial hypokalaemic periodic paralysis rec eived general anaesthesia for reduction of bilateral breast hyperplasia. Un complicated general anaesthesia was pet-formed using a propofol target-cont rolled infusion, remifentanil infusion and bolus doses of mivacurium with n euromuscular function monitoring. Plasma potassium concentrations were cont rolled intermittently in the peri-operative period and supplemented to achi eve normokalaemia. Despite continuous substitution, an episode of low plasm a potassium concentration occurred during the recovery period; this was wit hout any clinical signs of muscle paralysis or respiratory distress.