title: Peri-operative concerns in a patient with thyroid storm secondary to molar pregnancy.
abstract: Awareness of the presence of thyroid function abnormalities in patients with molar pregnancy is important for its prompt diagnosis and management. We report the development of thyroid storm in the immediate post-operative period in a 25-year-old female who underwent evacuation of her molar pregnancy under saddle spinal block after being controlled for her thyrotoxicosis with a combination of antithyroid drugs, iodine, steroids and adrenergic blocking agents. We advocate the use of esmolol infusions up to a maximum dose of 200 μg/kg/min for immediate haemodynamic management of the patient. Optimum time needed for stabilisation of the hyper metabolic state after initiation of antithyroid drugs is still not known and evacuation of molar pregnancy remains the only definitive management of the thyrotoxic state.
authors.affiliation: Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Tanvir
authors.initials: T
authors.lastname: Samra
authors.affiliation: Department of Anaesthesia and Intensive Care, Lady Hardinge Medical College, New Delhi, India.
authors.forename: Ranvinder
authors.initials: R
authors.lastname: Kaur
authors.affiliation: Department of Anaesthesia and Intensive Care, Lady Hardinge Medical College, New Delhi, India.
authors.forename: Neha
authors.initials: N
authors.lastname: Sharma
authors.affiliation: Department of Anaesthesia and Intensive Care, Lady Hardinge Medical College, New Delhi, India.
authors.forename: Lalita
authors.initials: L
authors.lastname: Chaudhary
keywords: Anaesthesia; anaesthetic techniques; human chorionic gonadotropin; hydatidiform mole; hyperthyroidism; obstetric