Pre-op euthyroidism Goiter? Patients with tachycardia and HTN consider cancellation Iodide Sodium Iodide, Iopanoic acid, Lugol’s solution ○ Block the release of hormone ○ Wolff-Chaikoff effect Beta-Blocker Cortisol Adrenal function? Thionamides PTU favored for decrease in peripheral conversion Cholestyramine Temp control Hydration With or without glucose?
Nerve damage Superior Laryngeal ○ Motor to Cricothyroid mm. aspiration Recurrent Laryngeal ○ Everything laryngeal except Cricothyroid Hoarseness, stridor, total airway obstruction Hypoparathyroidism Laryngospasm Hypothyroidism Tracheal Compression
“Big Blue” Nayak B., Burman K.: Thyrotoxicosis and Thyroid Storm. Endocrinology and Metabolism Clinics 35. (4): Pearce E., Braverman L.: Hyperthyroidism: advantages and disadvantages of medical therapy. Surgical Clinics of North America 84. (3): Franklyn JA.: The Management of Hyperthyroidism. New England Journal of Medicine 330 (24): abstract. Burch H.B., Wartofsky L.: Life-threatening thyrotoxicosis. Thyroid Storm. Endocrinology and Metabolism Clinics of North America 22: abstract.