Subclinical hypothyroidism: A cause for delayed recovery from anaesthesia?

A 41-year-old female patient, diagnosed to have right sphenoid wing meningioma, was electively scheduled for right fronto-temporo-parietal craniotomy and excision. On preanaesthetic evaluation, she weighed 40 kg and had no comorbid illnesses. She was started on phenytoin 100 mg tid and intravenous dexamethasone 6 mg qid for 4 days which was continued on the morning of surgery. Her examination and routine investigations were within normal limits. Computed tomography (CT) scan showed 5.5 × 5.3 cm tumour with midline shift (8 mm).

[1]  H. Prabhakar,et al.  Effects of Phenytoin Therapy on Bispectral Index and Haemodynamic Changes Following Induction and Tracheal Intubation , 2009, Indian journal of anaesthesia.

[2]  J. Coetzee,et al.  Principles of intravenous drug infusion , 2005 .

[3]  W. Pearson,et al.  Subclinical Hypothyroidism and the Risk of Hypercholesterolemia , 2004, The Annals of Family Medicine.

[4]  J M Milunsky,et al.  Unmasking Kabuki syndrome: chromosome 8p22–8p23.1 duplication revealed by comparative genomic hybridization and BAC‐FISH , 2003, Clinical genetics.

[5]  N. Niikawa,et al.  Kabuki make‐up syndrome: A review , 2003, American journal of medical genetics. Part C, Seminars in medical genetics.

[6]  V. Fatourechi.  Subclinical Hypothyroidism , 2002, Treatments in endocrinology.

[7]  M. Begleiter,et al.  Specific Genetic Diseases at Risk for Sedation/Anesthesia Complications , 2000, Anesthesia and analgesia.

[8]  R. Mirakhur,et al.  Neuromuscular effects of rocuronium in patients receiving beta-adrenoreceptor blocking, calcium entry blocking and anticonvulsant drugs. , 1997, British journal of anaesthesia.

[9]  J. Opitz,et al.  Kabuki make-up (Niikawa-Kuroki) syndrome: a study of 62 patients. , 1988, American journal of medical genetics.

[10]  Y. Kuroki,et al.  A new malformation syndrome of long palpebral fissures, large ears, depressed nasal tip, and skeletal anomalies associated with postnatal dwarfism and mental retardation. , 1981, The Journal of pediatrics.

[11]  K.,et al.  Neurosurgical Anesthesia , 1996 .