Anesthetic challenges in a case of Sheehan's syndrome posted for open reduction and internal fixation and nailing following fracture femur

Abstract

Sheehan's syndrome is postpartum hypopituitarism caused by necrosis of the pituitary gland due to severe hypotension or shock caused by massive hemorrhage during or after delivery. Patients with Sheehan's syndrome have varying degrees of pituitary hormone deficiency. There is increased sensitivity to barbiturates and opiates in patients with Sheehan's syndrome. They are more prone to hypotension, hypoxia, and hypothermia which must be addressed intraoperatively. Herein, we report successful anesthetic management of a patient with Sheehan's syndrome with distal third femoral shaft fracture for fixation who had numerous hormonal and electrolyte abnormalities. This case report emphasizes the importance of meticulous preanesthetic assessment, optimization, and perioperative management of patients with Sheehan's syndrome for successful management of the case.

Keywords

• electrolyte imbalance
• hypopituitarism
• postpartum hemorrhage
• sheehan's syndrome