Anaesthetic management of parathyroid crisis in a paraplegic patient during parathyroidectomy

Anaesthetic management of parathyroid crisis in a paraplegic patient during parathyroidectomy

Published: 09 Jan 2018

© Anaesthesia Cases / 2017-0110 / ISSN 2396-8397

Authors

Dr changping gu [1]
Dr Guanjun Li [2]
Dr Ming Hou [3]
Dr Hai Feng [4]
Dr Yanbin Bi [5]
Dr Yuelan Wang [5]
  • [1] Medical Doctor, Anesthesiology, Shandong Provincial Qianfoshan Hospital, Shandong, China
  • [2] Medical Doctor, Anesthesiology, Shandong provincial Jiaotong Hospital, Shandong, China
  • [3] Medical Doctor, Anesthesiology, Shandong provincial Qianfoshan Hospital, Shandong, China
  • [4] Medical Doctor, Anesthesiology, Shandong provincial Qianfoshan Hospital, Shandong
  • [5] Medical Director, Anesthesiology, Shandong provincial Qianfoshan Hospital, Shandong, China

Summary

Chronic renal failure is often accompanied by secondary hyperparathyroidism that can be effectively treated by parathyroid­ectomy. However, there is a risk of parathyroid crisis during the operation. A 64-year-old patient with paraplegia and chronic renal failure showed progression to hyperparathyroidism and developed parathyroid crisis during parathyroidectomy. Emergency treatment included rehydration, calciuresis, intravenous injection of vasoactive agents and bisphosphonate therapy to mitigate the life-threatening complications of hyperparathyroid crisis. The case shows that special attention needs to be paid to paraplegic patients undergoing parathyroidectomy.

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