GRAVES’ DISEASE; PREOPERATIVE PREPARATION WITH INORGANIC IODIDE – IS IT INDICATED?

The thyroid parenchyma in Graves’ disease is highly vascularized, thereby increasing the risk of hemorrhage/ hemorrhagic complications. Preoperative administration of inorganic iodine diminishes thyroid blood flow and vascularity as well as friability of thyroid tissue, making thyroidectomy easier and safer. In the past, a short course of preoperative administration of inorganic iodine was used to control patient’s hyperthyroidism (Wolff-Chaikoff effect). Inorganic iodine can be given as 5 – 7 drops of Lugol’s solution (containing KI, 8 mg iodine/drop) or 1-2 drops of  SSKI (50 mg/drop) three times daily, mixed in water or juice for 10 days before surgery. This preoperative preparation, however, was used only by one-third of surgeons in a recent European survey.

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