ANAESTHESIA IN UNTREATED MYXOEDEMA

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Abstract
General anaesthesia can precipitate cardiovascular collapse in patients with untreated myxoedema. This is illustrated by two case reports. Emergency surgery may be necessary in these patients but should be delayed for a few hours until therapy with triiodothyronine and cortisone has been started. Narcotic analgesics, sedatives, and tranquillizers should be avoided as they may cause marked respiratory depression. Hypothermia may develop but active rewarming is dangerous and unnecessary as the temperature will return to normal as soon as treatment with triiodothyronine is started. General anaesthesia may be satisfactorily carried out with nitrous oxide, oxygen, relaxants and positive pressure ventilation.

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