Acute baroreflex-mediated hemodynamic instability during thyroid surgery: A case report

Choi, Eun Kyung; Kwon, Hyojin; Park, Suyong

doi:10.4103/sja.sja_76_19

Cited by 2 publications

(4 citation statements)

References 10 publications

(12 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Acute intra-operative hemodynamic changes may be attributed to episodic surges of thyroid hormones or a neurogenic baroreflex phenomenon due to surgical manipulation near the carotid sinus. 3 , 4 Thyroid storm is an emergency situations characterized by persistent hypertension, tachycardia, hyperthermia, and end-organ damage. Anesthetic and surgical teams must prepare and run any activity to perform the surgery in an optimal condition.…”

Section: Discussionmentioning

confidence: 99%

“…Acute intra-operative hypertensive crises may be attributed to episodic surges of thyroid hormones (thyroid storm) or a neurogenic baroreflex phenomenon due to surgical manipulation near the carotid sinus. 3 , 4 Thyroid storm in an emergency situations characterized by persistent hypertension, tachycardia, hyperthermia, and end-organ damage. 4 The neurogenic baroreflex affects cardiac contractility, heart rate and systemic vascular resistance by mechanoreceptors those located around aortic arch and carotid arteries.…”

Section: Introductionmentioning

confidence: 99%

“… 3 , 4 Thyroid storm in an emergency situations characterized by persistent hypertension, tachycardia, hyperthermia, and end-organ damage. 4 The neurogenic baroreflex affects cardiac contractility, heart rate and systemic vascular resistance by mechanoreceptors those located around aortic arch and carotid arteries. This reflex exerts its effect via efferent pathways from vasomotor center in the brain.…”

Section: Introductionmentioning

confidence: 99%

“…This reflex exerts its effect via efferent pathways from vasomotor center in the brain. 4 Care attention to optimize pre-operative condition can decrease the rate of these crises. 3 The patient should be maintained in a euthyriod state and any preoperative hemodynamic or anxiety problems should be treated.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Effectiveness of the oral Clonidine as a pre-anesthetic medicine for thyroidectomy surgery; A randomized clinical trial

Zahedi,

Naghipour,

Zahedi

et al. 2023

J Cardiovasc Thorac Res

View full text Add to dashboard Cite

Introduction: Hemodynamic disturbance is a common problem in patients undergoing thyroid surgery. It may be due to episodic increases in thyroid hormones (thyroid storm) or stimulation of the carotid sinus baroreflex. The aim of the present study was to investigate effectiveness of the pre-operative oral Clonidine on reducing these hemodynamic changes during total thyroidectomy surgery. Methods: In a prospective, randomized, double-blind study, 80 patients scheduled for elective total thyroidectomy were randomized to receive either 0.2 mg Clonidine (n=40) or a matched placebo (n=40) orally sixty minutes before entering the operating room. Hemodynamic variables, the duration of surgery, estimated amount of blood loss and the dose of administered remifentanil were recorded for further analysis. Results: Oral Clonidine was found to be significantly better in maintaining stable hemodynamics compared to the control group. Also, In the Clonidine group, the estimated amount of blood loss (110.4±10 ml vs. 182.2±11.4 mL, P=0.04), duration of the surgery (78.26±55.2 min vs. 105.16±61.75 min, P=0.027) and administered dose of remifentanil (26.67±6.6 μg vs. 216.2±14.8 μg, P=0.01) were also significantly lower than the control group. Conclusion: Pre-operative administration of 0.2 mg oral Clonidine in patients undergoing total thyroidectomy results in improved perioperative hemodynamic stability and reduced response to perioperative stress.

show abstract

Section: Discussionmentioning

confidence: 99%