Anaesthesia for emergency exploratory Laparotomy in a Patient with undiagnosed Thyrotoxicosis: A Case Report

Abstract

OF, a 25-year-old female with a history of 3 previous unsuccessful pregnancies was referred from a peripheral hospital with a diagnosis of ectopic gestation. She had a thyroid swelling. Initial pulse rate and blood pressure were 168 beats per minute and 130/90 mmHg respectively. She was premedicated with oral atenolol 100 mg on suspicion of undiagnosed thyrotoxicosis and pulse rate and blood pressure dropped to 110 beats per minute and 100/60 mmHg respectively. A right salpingectomy was carried out under endotracheal anaesthesia with muscle relaxation.A thyroid function test done postoperatively revealed a raised T3 and T4 with reduced thyroid stimulating hormone (TSH). She had a successful recovery and was discharged home. Issues and anaesthetic management challenges specific to patients with undiagnosed thyrotoxicosis coming for emergency surgery are discussed.