Delayed Emergence from General Anesthesia

The incidence of perioperative morbidity associated with varying degrees of untreated thyroid disease is unknown, however major complications have been reported including severe hypotension or cardiac arrest, extreme sensitivity to opioids and anesthetics with prolonged unconsciousness, and myxedema coma. Myxedema coma is a rare and life-threatening illness the outcome of which has not been robustly studied in large numbers, partly due to its low incidence. This case illustrates the differential diagnosis of delayed emergence from general anesthesia and the value of a complete history and physical exam. Although delayed emergence from general anesthesia is not uncommon, recognizing the cause and instituting timely treatment is imperative in conditions where delayed therapy can increase morbidity and mortality