Expert: Ronald Levy, M.D. - 4/8/2009

Question
QUESTION: Hello, I recently had an elective surgery cancelled due to my mild-hyperthyroid.
My T4 in normal range but TSH low. The fear was to provoke a thyroid storm. I
was told to get my TSH higher and become eu or hypo thyroid in order to get
this surgery. If I do this is there still a risk of storm? I also am sensitive to
chemicals. Would local with sedation be safer? Thank you.

ANSWER: If you are euthyroid the chance of thyroid storn is very low. As for local with sedation, without knowing what kind of surgery you are having, I can't tell you if it's safer.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston

---------- FOLLOW-UP ----------

QUESTION: Hello and thank you for your reply. I am getting breast implants removed with
surrounding capsule from under the muscle . Would local and sedation be a
safer choice as far as thyroid storm?

Answer
No for several reasons. First it probably would be hard to cover that large an area with local but more important, if the local didn't work and it was the middle of the procedure, they would have to convert to a general anesthetic and then you're back to the original problem.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston