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KMID : 0390320130230010201
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Chungbuk Medical Journal
2013 Volume.23 No. 1 p.201 ~ p.205
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A Case of Unpredicted Thyrotoxic Crisis During the Anesthetic Induction
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Bae Jin-Ho
Yu Hyun-Jeong
Lim Seung-Woon
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Abstract
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Thyroid toxicosis occurred during anesthesia is a life-threatening event by the severe hemodynamic changes. A 31-year-old woman without a previous history of thyroid disesae was scheduled for tonsillectomy. During the anesthesia induction the blood pressure and the heart rate rapidly increased to 210/120 mmHg and 170 beat/min. An iv bolus of esmolol and labetalol were administered to stabilize the vital signs. On inspection of the patient in the operating room we found exophthalmos and enlargement of thyroid gland. The thyroid hormone tests obtained at the operating room suggested that the patient had Graves` disease. Three days after operation, vital signs were stabilized and the patient was discharged. We present a case of a previously unknown hyperthyroidism patient, with a tonsillar hypertrophy, presenting as a thyroid toxicosis on induction of anesthesia.
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KEYWORD
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Thyroid Storm, Anesthetic Induction, Preoperative Evaluation
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