Work

The preoperative thyroid function and perioperative course in patients with Graves' disease

Year: 2020

Type: article

Abstract: Graves' disease is an autoimmune disorder that induces increase in thyroid hormone production and release. Although euthyroid\nshould be desirable to ensure a safe operation, some patients still undergo thyroidectomy with hyperthyroidism. The aim\nof this study was to evaluate our preoperative strategies in patients with Graves' disease. A total of 186 patients underwent thyroidectomy for Graves' disease between 2003 and 2017. We gave all of these patients potassium iodide (KI) in order to\ndecrease their thyroid hormone levels. We compared the clinical factors among three groups defined by the value of serum\nfree triiodothyronine (FT3) after the administration of KI: (1) the good control group (n=126) with ≤6.0 pg/mL, (2) the fair control group (n=35) with >6.0 but ≤10.0 pg/mL, and (3) the poor control group (n=25) with >10.0 pg/mL. KI decreased the serum\nlevels of thyroid hormone. However, some patients still had hyperthyroidism, and the subsequent administration of corticosteroid\nreduced FT3 but not thyroxine. Regarding the intraoperative course, the heart rate at 1 h after beginning general anesthesia\nwas higher in the poor control group than in the good control group (p<0.05), and the proportion of patients given\nadrenergic beta-blocker was higher in the poor control group than in the other groups (p<0.01 each). One patient in the fair\ncontrol group experienced suspected thyroid storm after total thyroidectomy. The occurrence rate of other deteriorations was\nidentical among the three groups. With preparative KI and corticosteroid administration, almost all patients with Graves' disease were able to undergo thyroidectomy safely.

Source: Institutional Repositories DataBase (IRDB)

DOI: 10.11343/amn.63.79