Peri anaesthesia in thyroid cancer patients with uncontrolled hypertension

Abstract

The high incidence of case fatality in patients with hypertension as a comorbidity involving anaesthesia poses a challenge for anaesthetists. Effective management prioritises the prevention of excessive vasodilatation that can result in hypoxia, haemodynamic instability, and imbalance of pre- and post-induction Blood Pressure changes resulting in the need for careful selection of appropriate anaesthetic maintenance regimens. Here, we outline an anaesthetic approach for tyroidectomy in a patient with Thyroid Cancer who requires surgical intervention under special monitoring due to comorbid uncontrolled Hypertension and excessive vasodilatory changes during intra-anesthesia. This study used a single case observation method with the subject of a 57-year-old male patient diagnosed with thyroid cancer and uncontrolled hypertension. Data were collected comprehensively and longitudinally in three phases: pre, intra, and post-anesthesia. In thyroid cancer patients with hypertension, intravenous midazolam was effective for pre-anesthesia anxiety. However, high doses of isoflurane in the intra-anesthesia phase can cause hypotension, which requires close hemodynamic monitoring. Careful anesthesia management, including dose adjustment and monitoring, is important to prevent complications and ensure patient safety.