What are the anesthetic management considerations for patients with hyperthyroidism?
Nov 05, 2025
Source: Cainiu Health
Dr. Wang Lei
Introduction
In general, anesthetic management of patients with hyperthyroidism primarily includes evaluating the condition and controlling basal metabolism, selecting an appropriate anesthesia method, monitoring vital signs, managing the risk of thyroid storm, and providing postoperative pain control and emergence management. When performing anesthesia in such patients, strict adherence to professional protocols is required. A detailed analysis is as follows:
In general, the anesthetic management of patients with hyperthyroidism primarily includes evaluating the condition and controlling basal metabolism, selecting an appropriate anesthesia method, monitoring vital signs, managing the risk of thyroid storm, and providing postoperative pain relief and recovery management. If anesthesia is required for such patients, strict adherence to professional protocols is essential. A detailed analysis is as follows:
1. Evaluate the Condition and Control Basal Metabolism
Thyroid function tests should be performed to assess the severity of the disease. Medications are used to regulate the patient’s basal metabolic rate to near-normal levels, reducing the risk of hemodynamic fluctuations during anesthesia and preventing intraoperative complications caused by metabolic abnormalities.
2. Select an Appropriate Anesthesia Method
The choice of anesthesia depends on the type of surgery and the patient's physical status. For example, general anesthesia is commonly used for neck surgeries. General anesthesia helps stabilize respiration and circulation, avoids surgical interference with breathing, and facilitates intraoperative management.
3. Monitor Vital Signs
Continuous intraoperative monitoring of blood pressure, heart rate, oxygen saturation, and other parameters is crucial. Patients with hyperthyroidism are prone to tachycardia and blood pressure fluctuations. Real-time monitoring allows early detection of abnormalities, enabling timely interventions—such as medication—to maintain hemodynamic stability.
4. Manage the Risk of Thyroid Storm
Closely observe the patient's response during surgery. If early signs of thyroid storm—such as high fever or sudden tachycardia—occur, promptly administer antithyroid medications, cooling measures, and other treatments to prevent full-blown thyroid storm and ensure surgical safety.
5. Postoperative Pain Management and Recovery Care
Select suitable analgesics to alleviate postoperative pain and prevent pain-induced tachycardia. Enhance monitoring during the recovery phase to ensure adequate restoration of respiratory function and avoid complications such as respiratory depression.
In daily care, attention should be paid to the patient's surgical wound; keep the wound clean and dry to prevent infection. Guide the patient in maintaining a balanced diet to support nutrition, follow a regular作息 (daily routine), promote recovery, and schedule regular follow-up evaluations of thyroid function to adjust treatment plans promptly.
