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How do you prepare toxic goiter for total or subtotal thyroidectomy?

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Question ajoutée par khalid qamhyya , Consultant General Surgeon , Dr.Khalid Qamhyya Private clinic
Date de publication: 2016/05/04
Mahmoud abunaji
par Mahmoud abunaji , Consultant pediatric surgeon , King salman hospital

1. B - blocker /inderal .

2. Anti hypertensive .

3. Thionamides : ptu , methimazole .

Thyroxine to restore euthyroid

Dr Jamil Jamali
par Dr Jamil Jamali , Resident in cardiology , PAMCC CARDIAC CENTRE

Treat patient with antithyroid medicines , beta blockers, Lugosi iodine to restore euthyroid status

drsalman muhammad ali
par drsalman muhammad ali , gp , apple clinic

yes we make patient euthyroid before surgery

abdesselam berrehail
par abdesselam berrehail , Specialist General Surgery , Al kuwaiti hospital

bring the patient to euthyroid condition

use of Lugol prior to surgery

amira dimitri
par amira dimitri , general surgeon , Sudanese military corp

The aim of treatment is to make patient euthyroid or even hypothyroid.

- antithyroid  medication : neomercazole the dose is according to the clinical state of the patient & values of TFT and the urgency of the surgery .

 

- B blokers to treat the tachycardia patient usually has .

- Lugo iodide to decrease the vascularity of the goiter

Muhammad Ihsan
par Muhammad Ihsan , Consultant & HOD Department of General Surgery, Arar Central Hospital, Ar'Ar

before going for surgery first treat thyrotoxic state with antithyroid medications, propranolol & lugols iodine, otherwise throtoxic storm could develop

MURATAB ALI
par MURATAB ALI , Consultant General Surgery , MOH KSA

Assess pt clinically and biomedically.if pt have hyperthyroidism as in this case make the pt euthyroid by anti-thyroid drugs and beta blockrers.then assess for anaesthesia fitness and larangioscopy and general fitness.During surgery and post operatively be concious for thyroid storm make all drugs available to handle emergency like anti thyroid drugs ,beta blockers ,lugol iodine ,corticosteroids,cold sponging for hyperpyrexia and intra venous fluids.

qahtan Jumaah
par qahtan Jumaah , General Surgeon , Ehs

Preop.preparation by anti thyoid drug and beta blocker to make clinical and biochemical euthyroid before surgery with preop.laryngeoscope examination. 

Hisham Khidir
par Hisham Khidir , intern , Aseer Central Hospital

We have to guard against a thyroid storm that could happen due to manipulation of the thyroid gland . So the pt must be euthyroid and on suitable beta blockade . Plus standard pre op check ups

ghassan alkhairy
par ghassan alkhairy , CONSULTANT GENERAL SURGEON AND LAPAROSCOPIC SURGERY , TATHLEETH GENERAL HOSPITAL

first of all tft to make sure the levels of hormones are acceptable with the treatment if not we need to adjust treatment prior to immediate surgery extra dose given to avoid crisis

 

Nauman Ahmed
par Nauman Ahmed , Medical Officer , ADNOC OFFSHORE

Restoring U thyroid state in patient prior to opting for thyroidectomy

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