A 55-year-old female patient diagnosed with a solitary thyroid nodule accompanied with severe mitral stenosis due to a history of rheumatic heart disease was planned to undergo isthmolobectomy surgery with anaesthesia. Patients were assessed for American Society of Anesthesiologists (ASA) III physical status. General anaesthesia is performed with Endotracheal Tube (ETT) Non-King-King No. 7, breath control with muscle relaxants. Premedication with 1 mg midazolam and 150 mcg fentanyl, induction with 10 mg Propofol, and intubation with 40 mg rocuronium. Maintenance with Oxygen, Isoflurane, Fentanyl 0.5 mcg / kg IV every 45-60 minutes continuously and Atracurium 0.15 mg / kg BW IV every 30-45 minutes continuously. The surgery lasted for about 2 hours. During surgery the hemodynamic is relatively stable with a systolic blood pressure of 100-120 mmHg, a diastolic blood pressure of 45-70 mmHg, heart rate (HR) between 60-75 x / minute and oxygen saturation between 98-100%, bleeding during surgery approximately 200 cc, and urine output ± 200 cc. Postoperatively the patient is treated in the intensive room
Key words: general anaesthesia, isthmolobectomy, mitral stenosis
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