Most patients with goiter are asymptomatic. Consequently, thyroidectomy is usually a planned elective procedure. However, there are few reports of patients with goiter presenting with varying degrees of airway compromise necessitating emergency thyroidectomy. This situation presents considerable challenges to anesthetists. We present the case of an elderly woman who presented with a giant malignant goiter causing severe upper airway obstruction. There was associated pulmonary metastasis. Several anesthetic options were considered. Regional anesthesia (bilateral superficial cervical plexus block) was eventually chosen. The procedure was well tolerated and the intraoperative course was uneventful.
The case is presented and the anesthetic challenges discussed. To our knowledge, this is the first time regional anesthesia would be used for emergency thyroidectomy in a patient with giant goiter causing airway obstruction. Going without your pills? Buy cheap viagra online