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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