Two cases of hypothyroidism is describedhaving different outcome
CASE-1
Mrs N D, 67 yrs female was posted for rt sided knee replacement.. She was somewhat hefty 75 kg. No h/o hypertension, asthma. allergy, She was diabetic which is wel controlled.She was hypothyroid on medication for long time. All routine investigations were within normal limits and had a stable cardio Vascular status. There was a small rise in TSH 9.8. A repeat test showed TSH .6.7 Such a trivial thyroid dysfunction was taken very seriously. As planned she was given an epidural injection.
The operation went on well. Pt was resting well without any complaints with repeated doses of epidural. By 24 hours she had a renal suppression with very low urine output inspite of normal if fluid. She had not any episodes of unusual hypotension.
Whilre re evaluating the case she was found to be unusually more sedated with a single dose of tramadol.and from other clinical features like edema, lethergy,weakness etc. was noticed. With addition of thyroxin 150mcg by oral route her condition very quickly improved.
CASE-1
Mrs N D, 67 yrs female was posted for rt sided knee replacement.. She was somewhat hefty 75 kg. No h/o hypertension, asthma. allergy, She was diabetic which is wel controlled.She was hypothyroid on medication for long time. All routine investigations were within normal limits and had a stable cardio Vascular status. There was a small rise in TSH 9.8. A repeat test showed TSH .6.7 Such a trivial thyroid dysfunction was taken very seriously. As planned she was given an epidural injection.
The operation went on well. Pt was resting well without any complaints with repeated doses of epidural. By 24 hours she had a renal suppression with very low urine output inspite of normal if fluid. She had not any episodes of unusual hypotension.
Whilre re evaluating the case she was found to be unusually more sedated with a single dose of tramadol.and from other clinical features like edema, lethergy,weakness etc. was noticed. With addition of thyroxin 150mcg by oral route her condition very quickly improved.
CASE-II
