Anesthesia and Thyroid Surgery (The Never Ending Challenges) An essay

Abstract

he thyroid gland is a butterfly shaped gland or a shield shaped gland named after the thyroid cartilage which is formed of two lobes that are connected together with a median tissue mass called the thyroid isthmus. The thyroid gland has a very rich blood supply with abundant anastomosis. The blood flow reaching to the gland is about 5 times the weight of the gland. The arterial supply is from the superior thyroid artery, inferior thyroid artery and may be from thyroid ima artery. It is mandatory to ensure that patients are clinically and chemically euthyroid prior to embarking on elective thyroid surgery. The preoperative use of antithyroid drugs has greatly decreased the morbidity from thyroid surgery and made thyroid storm a rare complication. The goal of preoperative management is to restore a normal metabolic state before surgical intervention. It is important to ask about duration of the disease because a long standing goiter may give you an idea about long standing tracheal compression and possible tracheomalacia. It is mandatory to ask about symptoms of hyper and hypothyroidism and if there any respiratory symptoms such as dyspnea, stridor which may indicate airway compromise. Evidence of other systemic disease