Elevated TSH

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epidural man

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I found this statement curious and probably the implications pose a wonderful challange to me as a budding anesthesiologist....

This is the first case I can remember canceling in 3 years.

Anyway, if your patient had a TSH of 50 or so, how many would cancel the case?

We had one the other day and the case was cancelled.
 
Anyway, if your patient had a TSH of 50 or so, how many would cancel the case?

depends on how the patient presented (ie, if with bradycardia, florid myxedema, etc.), what the procedure was, and if the case was emergent. also, what is the fT4 and T3 levels? there may be a euthyroid patient here who has an abnormal TSH. gotta know how the patient looks clinically.

either way, you can give IV levothyroxine with fairly rapid results. so "cancel" may be a strong word where "delay" might suffice, depending on the exact nature of the problem.
 
either way, you can give IV levothyroxine with fairly rapid results. so "cancel" may be a strong word where "delay" might suffice, depending on the exact nature of the problem.

Delay implies a few hours. That case is cancelled
 
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