AI Summary & Key Takeaways
AI InsightTherefore we aimed to discuss anaesthetic management of a case who underwent vaginal hysterectomy with adrenal insufficiency and hypothyroidism and receives hormonal replacement therapy, first planned to perform epidural anaesthesia but because of the technical difficulties general anaesthesia was attempted.
📌 3 Key Takeaways
Abstract
After adrenalectomy and thyroidectomy which performed as a therapy of multiple endocrine neoplasia II (MEN II), adrenal insufficiency and hypothyroidism may occur. However in response to surgery, both cortisol and thyroid hormones are essential and should be replaced. For any reason if an anaesthesia method will be applied to these cases, regional block is more suitable which causes decreased metabolic and endocrine response. Therefore we aimed to discuss anaesthetic management of a case who underwent vaginal hysterectomy with adrenal insufficiency and hypothyroidism and receives hormonal replacement therapy, first planned to perform epidural anaesthesia but because of the technical difficulties general anaesthesia was attempted.
Özet
Multipl Endokrin Neoplazi II (MEN II) nedeniyle yapılan sürrenalektomi ve tiroidektomiyi takiben adrenal yetmezlik ve hipotiroidi gelişebilir. Oysa cerrahiye stres yanıtta gerek kortizol gerekse tiroid hormonları ana unsurlar olup; replasmanları gerekmektedir. Herhangi bir nedenle bu tür vakalara anestezi uygulaması gerektiğinde cerrahiye metabolik ve endokrin yanıtı azalttığı bilinen rejyonal bloklar daha uygun olacaktır. Bu nedenle vajinal histerektomi geçirecek olan, öncelikle epidural anestezi planladığımız ancak uygulama zorluğu nedeniyle genel anestezi vermek zorunda kaldığımız, adrenal yetmezlik ve hipotiroidi replasman tedavisi alan bir olguyu sunmayı amaçladık.