A child with congenital hypothyroidism posted for emergency surgery- anaesthesia challenges

Paediatric cases pose considerable anaesthetic challenges and are more challenging if they are posted for emergency surgeries with associated comorbidities like congenital hypothyroidism. Few reported cases of anaesthesia management of congenital hypothyroid cases are there in the literature. Challenges are due to the difficult airway, associated congenital anomalies and increased sensitivity to anaesthetic drugs. Knowledge of pathophysiology, preoperative optimization and proper selection and planning of anaesthesia techniques are essential for successful anaesthesia management of children with congenital hypothyroidism for emergency surgeries. Congenital hypothyroidism in a child poses significant challenges for anaesthesiologists because of altered physiology, airway anatomy and difficult airway and drug metabolism.