[A case of hypothyroidism found by delayed awakening after the operation]

We report a case of hypothyroidism found by delayed awakening after surgery. A 55-year-old male patient had been suffering from elevated creatine phosphokinase (CPK) and cartinoembryonic antigen (CEA) of unknown origin before the operation. Laparoscopic cholecystectomy was performed under general anesthesia combined with epidural block. Hypotension, low arterial oxygen saturation, hypothermia and metabolic acidosis developed and continued during the operation. Awakening was delayed for about two hours postoperatively. Specific examination resulted in a definitive diagnosis of hypothyoidism. We should pay careful attention to any patient with elevated CPK and CEA of unknown origin before surgery, continuous hypotension, respiratory and circulatory failure and metabolic disorder during surgery, and delayed awakening after surgery that may be the result of hypothyroidism.