Anaesthesia for amiodarone-induced thyrotoxicosis: A case review

Amiodarone-induced thyrotoxicosis is a life-threatening problem that is ver y effectively managed by total thyroidectomy, although often many of these patients are considered "too unfit" for anaesthesia. The aim of this study was to review the safety of anaesthesia for total thyroidectomy in the acut e management of amiodarone-induced thyrotoxicosis. Information was obtained retrospectively from a prospective endocrine surgi cal database and from hospital records. Data, including outcomes and morbid ity, are presented from 12 patients who underwent anaesthesia for total thy roidectomy as an urgent procedure for amiodarone-induced thyrotoxicosis. Despite the fact that these patients had uncontrolled thyrotoxicosis and ra nked cardiac failure at the time of anaesthesia, no anaesthetic or surgical mortality was seen. We conclude that a challenging patient with amiodarone -induced thyrotoxicosis that has not responded to conservative measures may be considered for total thyroidectomy early in their management. Total thy roidectomy can be performed under general ol local anaesthesia with apparen t relative safety.