Perioperative Management In Patient With Hypothyroidism

Perioperative Management In Patient With Hypothyroidism

Prof. Ashraf Aminorroaya
Isfahan Endocrine and Metabolism Research
Center, Isfahan University of Medical Sciences

Prevalence of Hypothyroidism

Hypothyroidism is a common endocrinopathy, and is more prevalent in women and

 with increasing age.

Primary hypothyroidism accounts for 95% of all cases.

The overall prevalence of hypothyroidism was 4.8%)Subclinical = 3.1(% in men and 12.8%

)Subclinical = 8.6 (%in women in Isfahan, Iran, 2006.

Within a 6-year follow-up, the incidence rate of hypothyroidism was 3.3 in women and 2.1 in men per 1000 (person-year)

Higher TPOAb concentration is its strong predictor of this incident.

Perioperative Management In Patient With Hypothyroidism

A significant number of patients who are undergoing surgery may have concomitant thyroid disease.

 Due to the effects of thyroid hormone throughout the body, the effects of thyroid dysfunction are may complicate surgical procedures and postoperative recovery.

*Palace MR. Perioperative Management of Thyroid Dysfunction. Health service Insight 2017:1-5

Should perioperative TSH be measured routinely?    

Routine screening to detect thyroid disease is not indicated in patients.

*where there is no index of suspicion hypothyroidism .

*Patients with taking thyroid medication on stable dose and euthyroidism was documented within the past 3 to 6 months.

* Manzullo Fe, Ross Ds. Nonthyroid surgery in the patient with thyroid disease. 2018: Available at https://www.uptodate.com/contents /nonthyroid-surgery-in-the-patient-with-thyroid-disease