Anesthetic management of thyrotoxicosis patient using total intravenous anesthesia: A case report

Park, Jung Kyu; Cho, Kwang Rae; Cheong, Soon Ho; Lee, Kun Moo; Lee, Jeong Han; Kim, Myoung hun; Lee, Wonjin; Lee, Ji yong

Case Report

Anesthetic Pharmacology

Anesthesia and Pain Medicine 2014;9(1):41-43.
Published online January 30, 2014.

Anesthetic management of thyrotoxicosis patient using total intravenous anesthesia: A case report

Jung Kyu Park, Kwang Rae Cho, Soon Ho Cheong, Kun Moo Lee, Jeong Han Lee, Myoung hun Kim, Wonjin Lee, Ji yong Lee

Department of Anesthesiology and Pain Medicine, Inje University Busan Paik Hospital, Busan, Korea. maeteost@hanmail.net

Received: 16 May 2013 • Revised: 14 June 2013

Abstract

It is uncommon that anesthesiologists experience patients with thyroid storms. In our case, the patient had been medicated for 5 years, however, she developed agranulocytosis. Anti-thyroid drugs were stopped and hyperthyroidism progressed. Her symptoms and laboratory results revealed manifestation of thyroid storm: TSH of < 0.005 IU/L, free T4 of > 7.77 ng/dl, T3 of 403.1 ng/dl, and T4 of 22.15 microg/dl. The euthyroid state had not been achieved before the surgery. From the judgment of difficulty controls of hyperthyroidism, the surgeon requested for an emergency operation. We report a case of total intravenous anesthesia with propofol and remifentanil which achieved hemodynamic stability.

Key Words: Hyperthyroidism, Intravenous anesthesia, Thyroid storm