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Hyperthyroidism is a preexisting disorder that is occasionally encountered by anesthesiologists during preanesthetic evaluations. Hyperthyroidism is usually accompanied by allergies, and there is a suggested relationship between the development of hyperthyroidism and the exacerbation of allergic disease. 1 Here, we report a case with palmoplantar pustulosis and hyperthyroidism diagnosed after simultaneous bimaxillary orthognathic surgery. The patient was a 39-year-old woman (height, 153.2 cm; weight, 48.4 kg) who suffered from

the present case, a remifentanil infusion was initiated at induction of anesthesia. The initial observed tachycardia quickly resolved, likely because of the sympatholytic effects of the remifentanil, and her cardiovascular dynamics became stable. This likely masked the underlying thyrotoxicosis and prolonged the time until it was noted and diagnosed. In patients with uncontrolled hyperthyroidism, the stress from surgery and/or general anesthesia can trigger a thyroid storm or thyrotoxicosis. The delirium, tachycardia, and nausea/vomiting following extubation

Dentistry, 244 Dexmedetomidine, 88, 221, 230 Dexamethasone, 136 Drug interactions, 253 Early childhood caries, 212 ECC, 212 Epinephrine, 221 Fasting duration, 226 Gastroesophageal reflux disease, 248 General anesthesia, 3, 29, 144, 162, 165, 226, 235, 248, 251 General anesthesia for elderly, 88 Hemodynamics, 226 Hyperglycemia, 39 Hyperthyroidism, 173 Hypoglycemia, 39

Deteriorating Palmoplantar Pustulosis and Hyperthyroidism After Simultaneous Bimaxillary Orthognathic Surgery (brief communications), 173 O'Halloran KD, see Brady P, 168 Ohshita N, Anesthetic Management of a Patient With Multiple Sclerosis (case report), 97 Okaysu I, see Sanuki T, 175 Omizo H, see Morota T, 171 Pardo-Kaba SC, see Rodrigues WC, 153 Pinheiro MLP, see Falci SGM, 136 Portnof J, see Nack B, 178 Reader A, see Bonar T, 203 Reebye U, Comparing the Efficiencies of Third Molar

Most patients who have a history of thyroid disorder are controlled and present in a euthyroid state. In this case, there is little concern regarding sedation and anesthesia. However, patients who have questionable control are a matter of concern whether hypoactive or hyperactive in their status. The hypothyroid patient can be very sensitive to central nervous system (CNS) depressants and is at increased risk for bradycardia, hypotension, hypothermia, and hypoglycemia. Patients medicated with thyroid replacement (eg, Synthroid) may be functionally hyperthyroid if

, diabetes mellitus, or hyperthyroidism. This study was approved by the Ethics Committee of the Nippon Dental University School of Life Dentistry, Tokyo, Japan (approval number NDU-T-2015-14). It was performed in accordance with the guidelines of that institution and of the Declaration of Helsinki and was conducted after clinical trial registration, as certified by the International Committee of Medical Journal Editors (trial identification number: UMIN000016644). Informed consent was obtained from all individual participants or legal guardians included in the

scale (100-mm horizontal line with the left end of the line corresponded to a scale of 0 mm marked as “no pain,” and the right end corresponded to a scale of 100 mm marked as “most severe pain”). CASE 1 A 55-year-old woman was scheduled for a difficult deep left mandibular wisdom tooth extraction in close proximity to the inferior alveolar nerve under general anesthesia. She was diagnosed with AERD at 28 years old and hyperthyroidism, now controlled, and hyperlipidemia at 55 years old. She was prescribed theophylline, procaterol

. 8 Martin WH 3rd , Korte E , Tolley TK , Saffitz JE . Skeletal muscle β-adrenoreceptor distribution and responses to isoproterenol in hyperthyroidism . Am J Physiol . 1992 ; 262 : E504 – E510 . 9 Thomas CW

regulate blood pressure. Changes in the aforementioned circulatory dynamics may have significantly improved the effects of local anesthetic vasoconstrictors in patients with hypertension, ischemic heart disease, or hyperthyroidism. The BIS monitor determines the degree of sedation due to changes in brain waves. 30 A BIS value of 60 or less indicates that consciousness has been lost, 60 to 90 indicates a state of sedation, and 90 or more indicates a state of unimpaired consciousness. The sedative effect of DEX after its local administration has not been clarified