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Canadian Journal of Anesthesia, Vol 29, 543-549, Copyright © 1982 by Canadian Anesthesiologists' Society

Myxoedema and Open Heart Surgery: Anaesthesia and Intensive Care Unit Experience

D. C. FINLAYSON M.D., F.R.C.P.(C)1 and JOEL A. KAPLAN M.D.1

1 The Cardiovascular Intensive Care Units and Division of Cardiothoracic Anesthesia, Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia

Myxoedema has been considered a major anaesthetic risk which could be increased by concurrent heart disease. Thyroid ablation with the production of myxoedema has, in the past, been used to control intractable angina. Eight ablated patients (Group I) and five patients with heart disease and incidental hypothyroidism (Group II) presented for open heart surgery. Management included diazepam-narcotic anaesthesia in generally reduced doses, careful monitoring and the use of digoxin, steroids and I-thyroxin given during or after operation. All patients survived. A number of the anaesthetic considerations and potential problems with myxoedema are discussed.

Key Words: COMPLICATIONS, myxoedema • SURGERY, open heart






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Copyright © 1982 by the Canadian Anesthesiologists' Society.