Thyroid hormones (T4 and T3) increase the metabolic rate, promote thermoregulation and calorigenesis, and stimulate oxygen consumption; they also increase the number and affinity of β-adrenergic receptors in the myocardium and increase the sensitivity of the heart to epinephrine. During surgical stress, T3 concentration is inversely related to both circulating epinephrine and cortisol concentrations; consequently, perioperatively thyroid hormone production is reduced.1-3
Two prospective surveys over a 10-year period, involving 4,309 dentists, documented a total of 30,602 medical emergencies of which only four were diagnosed as thyroid storms.10 These cases most likely were the results of hormone-drug interaction; i.e., high circulating thyroid hormone levels as a result of undiagnosed or inadequately treated hyperthyroidism, or over treated hypothyroidism) augmented the physiologic effect of epinephrine in the local anesthetic.
Your session is about to expire. Do you want to continue logged in?