Anaesthetic management of a large multi-nodular goitre with dynamic bilateral carotid artery compression.

Dynamic carotid compression arising from a change in patient position is a rare complication of goitre, with the potential for cerebral ischaemia and infarction. In this report, a 37-year-old woman presented with a multi-nodular goitre with clinical features concerning for transient cerebral ischaemia. The anaesthetic management and neurological monitoring used to mitigate the risk of cerebral ischaemia during thyroidectomy is described and the literature surrounding this rare complication is explored.

Glucagon-like peptide-1 receptor agonists: a narrative review of clinical pharmacology and implications for peri-operative practice.

Background: Glucagon-like peptide-1 receptor agonists are used increasingly in the management of patients living with type 2 diabetes mellitus and obesity. In patients using glucagon-like peptide-1 receptor agonists, a key concern in the peri-operative period is the increased risk of pulmonary aspiration due to delayed gastric emptying. This review provides an overview of the pharmacodynamic and pharmacokinetic properties of glucagon-like peptide-1 receptor agonists and the risk of delayed gastric emptying and aspiration.