66 old male cancer thyroid was operated and he is now on thyroid replacement herapy.He has recurrent thyroid cacer, in the preoperative assessment both T3 and T4 were higher than normal range and TSH was lower than normal. What is the best preanaesthetic management and if operated with these data what are the anaesthetic problems
Thanks for your question on Chat Doctor. In my opinion he is at present having hyperthyroidism.  So better to stop thyroid supplements and start beta blockers and antuthyroid Chat Doctor. We need to first normalize his thyroid hormones.  And then surgery should be done. Propofol will be the best anesthetic agent. And no need to hurry for surgery with high T3 and T4. If you do surgery with high levels chances of thyroid toxicity are more. Patient may have high blood pressure, perspiration, tachycardia and arrhythmia too. So better to first normalize thyroid hormones and then plan for surgery.