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Background <p>This case report described the entire process of a 72-year-old Chinese woman undergoing resection of a giant thyroid tumor. The novelty of this case report lies in its emphasis on the crucial role of anesthetic management for giant thyroid tumors, particularly in patients with concurrent cardiac comorbidities.</p> Case presentation <p>We present a 72-year-old Chinese female with a giant thyroid tumor caused respiratory compromise due to tracheal compression, complicated by atrial septal defect. She required general anesthesia for tumor resection. A multidisciplinary team developed critical contingency strategies: (1) awake endotracheal intubation under direct laryngoscopy, (2) a remimazolam/sufentanil combination for procedural tolerance, (3) improved tracheal catheter preparation, and (4) surgical tracheostomy readiness. Anesthesia maintenance was achieved with sevoflurane, supplemented by sufentanil and remifentanil for multimodal analgesia and vecuronium/mivacurium neuromuscular blockade. Successful tumor resection achieved complete decompression, with no postoperative complications documented during 30-day follow-up.</p> Conclusions <p>This case demonstrates that meticulous interdisciplinary communication and structured perioperative protocols form the cornerstone of safe anesthesia practice for patients with dual pathology of airway compromise and cardiac comorbidities, providing crucial insights for managing such complex clinical scenarios.</p>

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Anesthetic management of giant thyroid tumor with cardiac comorbidity causing tracheal compression: a case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月29日

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  • Haikun Zhang,
  • Jinxiang Yu,
  • Chengcheng Chen,
  • Le Cao,
  • Pengcheng Ma,
  • Lifeng Jia,
  • Nianliang Zhang,
  • Tao Zhao

摘要

Background

This case report described the entire process of a 72-year-old Chinese woman undergoing resection of a giant thyroid tumor. The novelty of this case report lies in its emphasis on the crucial role of anesthetic management for giant thyroid tumors, particularly in patients with concurrent cardiac comorbidities.

Case presentation

We present a 72-year-old Chinese female with a giant thyroid tumor caused respiratory compromise due to tracheal compression, complicated by atrial septal defect. She required general anesthesia for tumor resection. A multidisciplinary team developed critical contingency strategies: (1) awake endotracheal intubation under direct laryngoscopy, (2) a remimazolam/sufentanil combination for procedural tolerance, (3) improved tracheal catheter preparation, and (4) surgical tracheostomy readiness. Anesthesia maintenance was achieved with sevoflurane, supplemented by sufentanil and remifentanil for multimodal analgesia and vecuronium/mivacurium neuromuscular blockade. Successful tumor resection achieved complete decompression, with no postoperative complications documented during 30-day follow-up.

Conclusions

This case demonstrates that meticulous interdisciplinary communication and structured perioperative protocols form the cornerstone of safe anesthesia practice for patients with dual pathology of airway compromise and cardiac comorbidities, providing crucial insights for managing such complex clinical scenarios.