Skip to main content Skip to main navigation menu Skip to site footer

Risk factors in perioperative anesthesia management in multiple thyroid nodule surgery

  • Steven Steven ,

Abstract

Introduction: Thyroid nodules are the most common endocrine disorders (endocrine neoplasms). Conducting regular physical examinations in risk factors of thyroid nodules is essential. This case report aims to describe how multiple thyroid nodules could be why muscle relaxant administration was repeated in this patient in a short time.

Case Presentation: A 39 years old female, with clinical complaints of a lump in her neck. Right colli anterior region, fine needle aspiration biopsy (FNAB) gives a result the impression of cytomorphological picture is suspicious for papillary thyroid carcinoma. And the thyroid ultrasound examination results found the Impression of Single solid nodule with calcification on the right thyroid, multiple cystic nodules on the left thyroid, and bilateral multiple non-specific colli lymphadenopathy. The patient underwent total thyroidectomy, using General Anesthesia, with the muscle relaxant used, namely rocuronium, which was then carried out with a maintenance dose 3 times intraoperatively because the patient's spontaneous breathing returned while the operation was still in progress, after which the patient was transferred to the recovery room for post-operative monitoring.

Conclusion: Multiple thyroid nodules could be the reason why muscle relaxant (rocuronium) administration was repeated in this patient in a short time.

References

  1. Dean DS, Gharib H. Epidemiology of thyroid nodules. Best Pract & Res Clin Endocrinol & Metab. 2008;22(6):901–11. Available from: http://dx.doi.org/10.1016/j.beem.2008.09.019
  2. Desforges JF, Mazzaferri EL. Management of a Solitary Thyroid Nodule. N Engl J Med. 1993;328(8):553–9. Available from: http://dx.doi.org/10.1056/nejm199302253280807
  3. Uyar O, Cetin B, Aksel B, Dogan L, Beksac K, Akgul GG, et al. Malignancy in Solitary Thyroid Nodules: Evaluation of Risk Factors. Oncol Res Treat. 2017;40(6):360–3. Available from: http://dx.doi.org/10.1159/000464409
  4. Maxwell C, Sipos JA. Clinical Diagnostic Evaluation of Thyroid Nodules. Endocrinol Metab Clin North Am. 2019;48(1):61–84. Available from: http://dx.doi.org/10.1016/j.ecl.2018.11.001
  5. Tamhane S, Gharib H. Thyroid nodule update on diagnosis and management. Clin diabetes Endocrinol. 2016;2:17. Available from: https://pubmed.ncbi.nlm.nih.gov/28702251
  6. Permana IGKA. Impending thyroid crisis in toxic multinodal goiter with community-acquired pneumonia. J Penyakit Dalam Udayana. 2018;2(1):5–9. Available from: http://dx.doi.org/10.36216/jpd.v2i1.13
  7. Guo H, Sun M, He W, Chen H, Li W, Tang J, et al. The prevalence of thyroid nodules and its relationship with metabolic parameters in a Chinese community-based population aged over 40 years. Endocrine. 2013;45(2):230–5. Available from: http://dx.doi.org/10.1007/s12020-013-9968-0
  8. Kir S, Aydin Y, Coskun H. Relationship between metabolic syndrome and nodular thyroid diseases. Scand J Clin Lab Invest. 2017;78(1–2):6–10. Available from: http://dx.doi.org/10.1080/00365513.2017.1402363
  9. Rezzonico J, Rezzonico M, Pusiol E, Pitoia F, Niepomniszcze H. Introducing the Thyroid Gland as Another Victim of the Insulin Resistance Syndrome. Thyroid. 2008;18(4):461–4. Available from: http://dx.doi.org/10.1089/thy.2007.0223
  10. Kimura T, Van Keymeulen A, Golstein J, Fusco A, Dumont JE, Roger PP. Regulation of Thyroid Cell Proliferation by TSH and Other Factors: A Critical Evaluation of in Vitro Models. Endocr Rev. 2001;22(5):631–56. Available from: http://dx.doi.org/10.1210/edrv.22.5.0444
  11. Jornayvaz FR, Lee H-Y, Jurczak MJ, Alves TC, Guebre-Egziabher F, Guigni BA, et al. Thyroid hormone receptor-α gene knockout mice are protected from diet-induced hepatic insulin resistance. Endocrinology. 2011/12/06. 2012;153(2):583–91. Available from: https://pubmed.ncbi.nlm.nih.gov/22147010
  12. Bomeli SR, LeBeau SO, Ferris RL. Evaluation of a thyroid nodule. Otolaryngol Clin North Am. 2010;43(2):229–vii. Available from: https://pubmed.ncbi.nlm.nih.gov/20510711
  13. Naguib M, Samarkandi AH, Bakhamees HS, Magboul MA, el-Bakry AK. Comparative potency of steroidal neuromuscular blocking drugs and isobolographic analysis of the interaction between rocuronium and other aminosteroids. Br J Anaesth. 1995;75(1):37–42. Available from: http://dx.doi.org/10.1093/bja/75.1.37
  14. Magorian T, Flannery KB, Miller RD. Comparison of Rocuronium, Succinylcholine, and Vecuronium for Rapid-sequence Induction of Anesthesia in Adult Patients. Anesthesiology. 1993;79(5):913–8. Available from: http://dx.doi.org/10.1097/00000542-199311000-00007
  15. Saitoh Y, Toyooka H, Amaha K. Retracted: Recoveries Of Post-Tetanic Twitch And Train-Of-Four Responses After Administration Of Vecuronium With Different Inhalation Anaesthetics And Neuroleptanaesthesia. Br J Anaesth. 1993;70(4):402–4. Available from: http://dx.doi.org/10.1093/bja/70.4.402
  16. Lien CA. Development and potential clinical impact of ultra-short acting neuromuscular blocking agents. Br J Anaesth. 2011;107:i60–71. Available from: http://dx.doi.org/10.1093/bja/aer341

How to Cite

Steven, S. (2024). Risk factors in perioperative anesthesia management in multiple thyroid nodule surgery. Intisari Sains Medis, 15(1), 291–293. https://doi.org/10.15562/ism.v15i1.1979

HTML
0

Total
0

Share

Search Panel