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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Recurrent Thyroid Cancer?

66 old male cancer thyroid was operated and he is now on thyroid replacement herapy.He has recurrent thyroid cacer, in the preoperative assessment both T3 and T4 were higher than normal range and TSH was lower than normal. What is the best preanaesthetic management and if operated with these data what are the anaesthetic problems
Tue, 2 Dec 2014
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Pulmonologist,  's  Response
Thanks for your question on HCM.
In my opinion he is at present having hyperthyroidism. So better to stop thyroid supplements and start beta blockers and antuthyroid drugs like carbimazole.
We need to first normalise his thyroid hormones. And than surgery should be done.
Propofol will be the best anaesthetic agent.
And no need to hurry for surgery with high T3 and T4. If you do surgery with high levels chances of thyroid toxicity are more. Patient may have high blood pressure, perspiration, tachcardia and arrhythmia too.
So better to first normalise thyroid hormones and than plan for surgery.
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What Causes Recurrent Thyroid Cancer?

Thanks for your question on HCM. In my opinion he is at present having hyperthyroidism. So better to stop thyroid supplements and start beta blockers and antuthyroid drugs like carbimazole. We need to first normalise his thyroid hormones. And than surgery should be done. Propofol will be the best anaesthetic agent. And no need to hurry for surgery with high T3 and T4. If you do surgery with high levels chances of thyroid toxicity are more. Patient may have high blood pressure, perspiration, tachcardia and arrhythmia too. So better to first normalise thyroid hormones and than plan for surgery.