Abstract:
A 24-year-old male thyrotoxic student of a tertiary institution had thyroidectomy in the presence of a persistently elevated
thyroxine (T4) and tri-iodothyronine (T3) levels. He was initially managed for hypertension at a private hospital before he
was referred to our hospital for expert management. He had symptoms of thyrotoxicosis three years before presentation
at our hospital. Physical examination revealed bilateral anterior neck masses and a diagnosis of toxic goitre was made.
The serum T3 and T4 were elevated. Chest X-Ray, electrocardiogram and echocardiography showed abnormal findings.
He was commenced on antithyroid drugs. Surgery was postponed several times due to persistently elevated thyroid
hormones. However, he developed cardiac failure after six months on medical treatment and was treated with digoxin
and frusemide. He had thyroidectomy under general anesthesia after his cardiovascular status was optimized in order
to prevent further deterioration of his cardiac function. The anesthetic management is presented and discussed.
