Spinal Anesthesia in a Patient with Hyperthyroidism Due to Hydatidiform Mole

Clinical thyrotoxicosis is one of the rare complications of molar pregnancy. The cause of the symptoms associated with hyperthyroidism in mol hydatiform is the thyrotrophic effects of high levels of β-hCG. The hCG molecule consists of α and β subunits; the α subunit is identical to TSH and the β subunit has a similar structure to TSH. In this case report it was aimed to discuss the anesthetic management of a dilatation and curettage case in a patient with mol hydatiform and thyroid crisis. J Clin Exp Invest 2012; 3 (3): 433-434

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“…Bu hastalara genel anestezi 11 ve TİVA 12 uygulanabildiği gibi rejyonel anestezide 13 bir diğer alternatiftir.…”

Section: Discussionunclassified

Molar gebeliğin tetiklediği tiroid krizinde anestezik yaklaşım [Anesthetic management in thyroid crisis triggered by molar pregnancy]

Aydoğan

Yalçın²,

Küçük³

et al. 2012

J Clin Exp Invest

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“…Preoperative evaluation of these patients should be based on history, physical examination and laboratory testing [64]. The patient must be admitted to an intensive care unit preoperatively.…”

Section: Preoperative Preparationmentioning

confidence: 99%

“…If there is no time to make the patient pharmacologically euthyroid, intravenous administration of iodine and β-adrenergic receptor blockers for emergency treatment of hyperthyroidism may be advisable [65]. These drugs, however, may be hazardous in patients who have heart failure or pulmonary complications [64]. The role of plasmapheresis for the rapid hormonal control in the preoperative period has been described.…”

Section: Preoperative Preparationmentioning

confidence: 99%

“…Uterine relaxation caused by inhaled anaesthetics may however increase blood loss [69]. Hence inhaled anaesthetics with known tocolytic qualities such as halothane, enflurane and isoflurane should be used in lower concentrations [64]. A nitrous oxide, opioid, muscle relaxant technique may also be preferred [51,64].…”

Section: Anaesthetic Managementmentioning

confidence: 99%

“…Hence inhaled anaesthetics with known tocolytic qualities such as halothane, enflurane and isoflurane should be used in lower concentrations [64]. A nitrous oxide, opioid, muscle relaxant technique may also be preferred [51,64]. The safe use of sevoflurane at 2.5 % concentrations has been reported by some authors without increasing the chances of bleeding due to uterine relaxation [51].Drugs that minimally affect the cardiovascular system are the most rational choice in these patients [69].…”

Section: Anaesthetic Managementmentioning

confidence: 99%

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Trophoblastic Hyperthyroidism and Its Perioperative Concerns

Kurdi¹

2014

Thyroid Disorders - Focus on Hyperthyroidism

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Anesthetic management of a patient with hyperthyroidism due to hydatidiform mole

Matsumoto¹,

Shingu²,

Hidaka³

et al. 2009

J Anesth

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Secondary hyperthyroidism can often complicate gestational trophoblastic disease, a malignant uterine cancer. We report here the perioperative management of hyperthyroidism due to hydatidiform mole. A 53-year-old woman underwent emergency surgery due to suspicion of hydatidiform mole. Tachycardiac atrial fibrillation was detected by electrocardiography at the preoperative examination. No abnormalities were found in blood count, coagulation, biochemical tests, chest radiographs, or respiratory function. General anesthesia with nitrous oxide, oxygen, and sevoflurane, combined with fentanyl and 1% mepivacaine, was administered intermittently from an epidural catheter. Intraoperative events included hypotension and tachycardia, although in general, tachycardia was prevented with antiarrhythmic agents and transfusion with a plasma expander and crystalloid fluid. Hyperthyroidism was highly suspected from the patient's clinical course and was confirmed by high levels of preoperative serum free triiodothyronine (T3) and thyroxine (T4). The patient became euthyroid within a few days after mole evacuation and did not require an antiarrhythmic agent after her return to the inpatient ward.

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Spinal Anesthesia in a Patient with Hyperthyroidism Due to Hydatidiform Mole

Cited by 18 publications

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Molar gebeliğin tetiklediği tiroid krizinde anestezik yaklaşım [Anesthetic management in thyroid crisis triggered by molar pregnancy]

Molar gebeliğin tetiklediği tiroid krizinde anestezik yaklaşım [Anesthetic management in thyroid crisis triggered by molar pregnancy]

Trophoblastic Hyperthyroidism and Its Perioperative Concerns

Anesthetic management of a patient with hyperthyroidism due to hydatidiform mole

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