Total intravenous anesthesia for evacuation of a hydatidiform mole and termination of pregnancy in a patient with thyrotoxicosis.
Clinical hyperthyroidism is found in approximately 5% of women with a hydatidiform mole, as human chorionic gonadotropin secreted by molar tissue is structurally similar to thyroid-stimulating hormone. A hydatidiform mole occasionally presents with a co-existing viable fetus. Surgical evacuation may be indicated for significant hemorrhage or preeclampsia. Perioperative management in the presence of hyperthyroidism may be complicated by a thyroid storm. We report a case of total intravenous anesthesia with propofol and remifentanil, combined with an esmolol infusion, to control sympathetic hyperactivity during surgery.
Erturk
E
E
Karadeniz Technical University, Medical Faculty, Department of Anesthesiology, Trabzon, Turkey. engin_md@yahoo.com
Bostan
H
H
Geze
S
S
Saracoglu
S
S
Erciyes
N
N
Eroglu
A
A
D000028:Abortion, Induced; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000771:Anesthesia, Intravenous / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000008:administration & dosage; D013956:Antithyroid Agents / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006828:Hydatidiform Mole / Q000150:complications* / Q000601:surgery; D008713:Methimazole / Q000008:administration & dosage; D010880:Piperidines / Q000627:therapeutic use; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic; D011412:Propanolamines / Q000627:therapeutic use; D015742:Propofol / Q000627:therapeutic use; D011433:Propranolol / Q000008:administration & dosage; D000077208:Remifentanil; D013960:Thyroid Function Tests; D013971:Thyrotoxicosis / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D014594:Uterine Neoplasms / Q000150:complications* / Q000601:surgery
D000319:Adrenergic beta-Antagonists; D018686:Anesthetics, Intravenous; D000959:Antihypertensive Agents; D013956:Antithyroid Agents; D010880:Piperidines; D011412:Propanolamines; D008713:Methimazole; D011433:Propranolol; C036604:esmolol; D000077208:Remifentanil; D015742:Propofol