[Anesthetic management of a patient with mild hypothyroidism].
A patient with mild hypothyroidism underwent a repair of abdominal aortic aneurysm. Although the serum TSH level of this patient was very high and T4, free T4 levels were low, T3 level remained within normal ranges. Inhalation anesthesia with continuous epidural block was selected and there was no complication such as hypotension or hypothermia during perioperative period. Recently, several reports demonstrate that the preoperative supplemental therapy of the thyroid hormone should not be necessary in the case of mild hypothyroidism. Moreover, the biological potency of T3 is higher than that of T4. Thus, in patients whose T3 level is kept within normal ranges even if serum T4 level is low and serum TSH level is high, we may say that they are in euthyroid state. We think these patients can be anesthetized safely.
Koitabashi
T
T
Department of Anesthesiology, Saitama Medical Center, Saitama Medical School, Kawagoe.
Asai
I
I
Katayama
A
A
Sekiguchi
H
H
Tomita
K
K
Miyao
H
H
Kawasaki
J
J
Kawazoe
T
T
D000767:Anesthesia, Epidural; D000769:Anesthesia, Inhalation; D017544:Aortic Aneurysm, Abdominal / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000150:complications*; D008875:Middle Aged