Preoperative Management of Patients with Thyrotoxicosis

Preoperative Management of Patients with Thyrotoxicosis

Rezvan  Salehidoost, M.D.
Isfahan Endocrine and Metabolism Research Center
Isfahan University of Medical sciences

Agenda

• Preoperative Management of Patients with Thyrotoxicosis for Nonthyroid Surgery
• Preoperative Management of Patients with Hyperthyroidism who are to Undergo Thyroid Surgery
• Preoperative Management of Patients with Thyrotoxicosis for Nonthyroid Surgery
• Preoperative Management of Patients with Hyperthyroidism who are to Undergo Thyroid Surgery

Clinical  manifestations  that  may  impact perioperative  outcome

Dyspnea may occur for a variety of reasons, including:

• respiratory muscle weakness
• decreased lung volume
• increased basal oxygen consumption
• increased carbon dioxide (CO2) production

Patients with hyperthyroidism who are undergoing surgery are at risk for developing thyroid storm,  a scenario characterized by tachycardia, confusion, fever, gastrointestinal complaints, and potentially leading to cardiovascular collapse.

Thyroid storm usually occurs during surgery or in the first 18 hours after the procedure. The mortality rate for patients with thyroid storm can be as high as 40 percent.