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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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    Suggest treatment for hypothyroidism and spinal anaesthesia

Respected madam, I am an anaesthesiologist working in a sudivision hospital . Recently i had a pt of hypothyroidism going for cs. her starting BP was 90 systolic. i gave crystalloids before, done 2 iv channels in two hands with colloid in one. as it was emergency cs , I had to proceed. after spinal anaesthesia, I had faced a stormy episode, with pt had all sorts of trooubles stating from nausea to hypotension and everything .I had managed everrything by giving mephenteramine to hydrocortisone .but her bp remained static at 86 systolic.lastly I gave her phenylephrine iv. bp elevated but only to come down to below 90 a fter.Madam , u may blame me for not giving GA in this case; but as her thyroid status was not known ,I went for spinal.2 days are over in postop. her bp still below 90. she is doin fine in ward . Madam please explan what went wrong in this cae.
Mon, 2 Dec 2019
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Endocrinologist 's  Response
Hello,

If her TSH level is normal, it is not due to thyroid pathology but I would suggest to check adrenal function.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Mirjeta Guni, Endocrinologist
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