Open AccessPeri-operative concerns in a patient with thyroid storm secondary to molar pregnancy
Author(s) -
Tanvir Samra,
Ranvinder Kaur,
Neha Sharma,
Lalita Chaudhary
Publication year - 2015
Publication title -
indian journal of anaesthesia/indian journal of anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.645
H-Index - 30
eISSN - 0976-2817
pISSN - 0019-5049
DOI - 10.4103/0019-5049.170035
Subject(s) - medicine , thyroid storm , pregnancy , molar pregnancy , molar , esmolol , thyroid function , thyroid , thyroidectomy , anesthesia , surgery , gestation , heart rate , dentistry , genetics , blood pressure , biology
Awareness of the presence of thyroid function abnormalities in patients with molar pregnancy is important for its prompt diagnosis and management. We report the development of thyroid storm in the immediate post-operative period in a 25-year-old female who underwent evacuation of her molar pregnancy under saddle spinal block after being controlled for her thyrotoxicosis with a combination of antithyroid drugs, iodine, steroids and adrenergic blocking agents. We advocate the use of esmolol infusions up to a maximum dose of 200 μg/kg/min for immediate haemodynamic management of the patient. Optimum time needed for stabilisation of the hyper metabolic state after initiation of antithyroid drugs is still not known and evacuation of molar pregnancy remains the only definitive management of the thyrotoxic state.