title: [Successful anesthetic management of a patient with thyroid storm using landiolol].
abstract: We report successful anesthetic management of a 38-year-old man with thyroid storm using an ultra-short acting beta blocker, landiolol. The patient was admitted to the hospital for severe abdominal pain. An emergency laparotomy was scheduled for perforated gastric ulcer under a condition of uncontrolled thyrotoxicosis. On arriving the operating room, he showed tachycardia of 140 beats x min(-1) and blood pressure of 140/75 mmHg and high fever of 39 degrees C with tremor, sweating and diarrhea. He was anesthetized with oxygen, nitrous oxide, sevoflurane and fentanyl. Heart rate was around 130 beats x min(-1), and the landiolol was given continuously at a rate of 0.02-0.04 microg x kg(-1) x min(-1). Heart rate was controlled bellow 120 beats x min(-1) without hypotension during anesthesia. Thiamazole and inorganic iodine were given through an enterostomy tube postoperatively, and heart rate decreased gradually. He was extubated on the third postoperative day without any sequelae.
authors.affiliation: Department of Anesthesia, Okayama Red Cross General Hospital, Okayama 700-8607.
authors.forename: Tomihiro
authors.initials: T
authors.lastname: Fukushima
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Tokioka
authors.forename: Fumiko
authors.initials: F
authors.lastname: Ishii
authors.forename: Takeshi
authors.initials: T
authors.lastname: Mikane
authors.forename: Satoru
authors.initials: S
authors.lastname: Oku
authors.forename: Hiromi
authors.initials: H
authors.lastname: Fujii
authors.forename: Daisuke
authors.initials: D
authors.lastname: Katayama
authors.forename: Susumu
authors.initials: S
authors.lastname: Kawanishi
authors.forename: Junko
authors.initials: J
authors.lastname: Kosaka
authors.forename: Yuri
authors.initials: Y
authors.lastname: Nagano
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D000328:Adult; D000769:Anesthesia, Inhalation; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008713:Methimazole / Q000008:administration & dosage; D009025:Morpholines / Q000008:administration & dosage*; D010439:Peptic Ulcer Perforation / Q000209:etiology / Q000601:surgery*; D019990:Perioperative Care; D013276:Stomach Ulcer / Q000150:complications* / Q000601:surgery; D013958:Thyroid Crisis / Q000150:complications* / Q000188:drug therapy; D016896:Treatment Outcome; D014508:Urea / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D000319:Adrenergic beta-Antagonists; D009025:Morpholines; D008713:Methimazole; C077049:landiolol; D014508:Urea