Abstract We report a case of intraoperative normothermic tachyarrhythmic hypertensive crisis in a young healthy male posted for laparoscopic appendectomy. This hypertensive crisis was induced after glycopyrrolate injection given for bradycardia. We were unable to treat it with repeated doses of propofol and dexmedetomidine; we finally managed with intravenous esmolol, used as a rescue drug for unexplained tachycardia and severe hypertension. It was found to be an unusual presentation of thyroid storm, rather than an exaggerated response to tracheal intubation or to glycopyrrolate, as confirmed by postoperative thyroid-stimulating hormone and free T4 levels.
Tauheed et al. (Thu,) studied this question.