In thyroid surgery, the preoperative assessment of airway and effective dealing with acute airway complications are very important. All elective surgical procedures, including subtotal thyroidectomy, should be postponed until the patient is rendered euthyroid with medical treatment. Hypothyroid patients are more susceptible to the hypotensive effect of anesthetic agents because of their diminished cardiac output, blunted baroreceptor reflexes, and decreased intravascular volume. Since hyperthyroidism does not increase anesthetic requirements, there is no change in minimum alveolar concentration. The most serious threat to hyperthyroid patients in the postoperative period is thyroid storm, which is characterized by hyperpyrexia, tachycardia, altered consciousness, and hypotension. Obtaining sufficient know ledge, careful differential diagnosis and treatment of thyroid storm are other responsibilities of the anesthetist.
Keywords: thyroid disease, general anesthesia, thyroid crisis