Persistent intraoperative sinus tachycardia: threat of thyroid storm? A case report

Authors

  • Shubhada Rajendra Deshmukh Department of Anaesthesiology, NKP Salve Institute of Medical Sciences & Research Centre, Nagpur, Maharashtra
  • Heena Pahuja Department of Anaesthesiology, NKP Salve Institute of Medical Sciences & Research Centre, Nagpur, Maharashtra
  • Supriya Palsodkar Department of Anaesthesiology, NKP Salve Institute of Medical Sciences & Research Centre, Nagpur, Maharashtra
  • Rasika Jagtap Department of Anaesthesiology, NKP Salve Institute of Medical Sciences & Research Centre, Nagpur, Maharashtra

Keywords:

Unexplained intraoperative tachycardia, Thyroid storm

Abstract

Sinus tachycardia in a patient undergoing surgery under general anaesthesia is not an uncommon experience in anaesthesia practice. Causes of intraoperative sinus tachycardia can be multi-factorial. Operative causes are pain, surgical stimulation and light depth of anaesthesia. Pharmacological factors include administration of catecholamines, atropine, or ketamine. Medical factors such as sepsis, hypovolaemia, heart failure, anaemia, and thyrotoxicosis should also be considered. We report a case of inadequately controlled hyperthyroidism undergoing surgery for a spinal cord tumour under general anaesthesia who developed unexplained tachycardia intraoperatively.

References

Robson NJ. Emergency surgery complicated by thyrotoxicosis and thyrotoxic periodic paralysis. Anaesth. 1985;40:27-31.

Hutchins D. Peri-operative cardiac arrhythmias: part 1. Supraventricular Arrhythmias. Anaesth Tutor Week. 2013;279:6.

Langley RW, Burch HB. Perioperative management of thyrotoxic patient. Endocrinol Metab Clin N Am. 2003;32:519-34.

Tay S, Khoo E, Tancharoen C, Lee I. Beta blockers and the thyrotoxic patient for thyroid and non-thyroid surgery: a clinical review. OA Anaesthetics. 2013 Mar;1(1):5.

Hollander JM, Davies TF. Grave’s disease. In: Wondisford FE, eds. Clinical Management of Thyroid Diseases. 1st ed. Philadelphia: Saunders Elsevier; 2009: 176.

Hollander JM, Davies TF. Grave’s disease. In: Wondisford FE, eds. Clinical Management of Thyroid Diseases. 1st ed. Philadelphia: Saunders Elsevier; 2009: 155.

Roffi M, Cattaneo F, Topol EJ. Thyrotoxicosis and the cardiovascular system: Subtle but serious effects. Available at http://www.ccjm.org/content/70/1/57.full.pdf. Accessed 25 March 2014.

Hollander JM, Davies TF. Grave’s disease. In: Wondisford FE, eds. Clinical Management of Thyroid Diseases. 1st ed. Philadelphia: Saunders Elsevier; 2009: 177.

Nayak B, Burman K. Thyrotoxicosis and Thyroid Storm. Endocrinol Metab Clin N Am. 2006;35:663-86.

So PC. Unmasking of thyrotoxicosis during anaesthesia. Hong Kong Med J. 2001;7(3):311-4.

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Published

2017-01-24

How to Cite

Deshmukh, S. R., Pahuja, H., Palsodkar, S., & Jagtap, R. (2017). Persistent intraoperative sinus tachycardia: threat of thyroid storm? A case report. International Journal of Research in Medical Sciences, 2(3), 1168–1171. Retrieved from https://www.msjonline.org/index.php/ijrms/article/view/2380