Patient (condition)
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Topic aliases are alternate phrasings for a particular topic.
Thyrotoxicosis
Thyrotoxicosis is the hypermetabolic condition associated with elevated levels of free thyroxine (FT4) and/or free triiodothyronine (FT3). Anesthetic considerations include adequate preoperative optimisation to a euthyroid state, avoiding thyroid storm if optimisation is unable to be achieved in the event of emergency surgery, and thorough assessment to rule out airway compression or superior vena cava syndrome.
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Dec 10, 2012
Continue beta blockers to the day of surgery. Withholding beta blockers may increase the risk of intraoperative thyroid storm. (? adrenergic blockade prevents peripheral conversion of T4 to T3).
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Dec 03, 2012
If symptomatic hyperthyroidism is present, consider delaying elective surgery until the patient is assessed and stabilised to a euthyroid state by an endocrinologist. This may take 6-8 weeks. Poorly optimised hyperthyroidism places the patient at risk of haemodynamic instability and perioperative thyroid storm. Treatment options include beta blocker therapy, carbimazole, propylthiouracil, ablative therapy with radioactive iodine, and Lugolds iodine. refl.in/jm
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Dec 03, 2012
In severe thyrotoxicosis due to graves disease or subacute thyroiditis, to reduce the vascularity of the thyroid gland and inhibit the release of thyroid hormone to decrease the risk of perioperative thyroid storm, Lugol's iodide solution or supersaturated potassium iodide (SSKI) should be administered preoperatively, 3 drops twice daily beginning 10 days preoperatively. refl.in/jq
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Sep 28, 2011
To minimise the risk of precipitating a thyroid storm, especially in suboptimally optimised emergency cases, minimise sympathetic stimulation from pain or hemodynamic instability. Ensure patient is adequately analgesed at laryngoscopy, throughout case, and treat hypotension early.
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Sep 28, 2011