+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Propranolol in the treatment of thyrotoxicosis by subtotal thyroidectomy

Propranolol in the treatment of thyrotoxicosis by subtotal thyroidectomy

Journal of Clinical Endocrinology and Metabolism 43(6): 1312-1316

Subtotal thyroidectomy was performed in 40 patients with thyrotoxicosis in whom propranolol alone was used as preparation for surgery. Propranolol was given orally in a dose of 40 mg every 6 h for a mean preoperative period of 17 days (range 4-60 days) and continued for seven days after operation. The mean +/- SE blood loss at operation was only 160 +/- 20 ml. The period of follow-up was from three to nine months. Recurrent thyrotoxicosis has not occurred in any patient. Low levels of total serum triiodothyronine (T3) and total serum thyroxine (T4) were observed in the early postoperative weeks in some patients and were associated with symptoms of mild hypothyroidism, but by six months in the presence of a raised serum thyrotropin (TSH) the thyroid hormone levels returned to normal. Permanent hypothyroidism developed in only two patients. Despite normal or low total serum T3 and T4 levels, the TSH response to thyrotropin-releasing hormone (TRH) was absent in all patients one week after operation. At four weeks and at eight weeks, the response was absent or sub-normal in 70% and 20% of the patients respectively, indicating a delay in the recovery of the hypothalamo-pituitary axis previously exposed to high levels of T3 and T4. It is considered that subtotal thyroidectomy for thyrotoxicosis in patients prepared with propranolol is an acceptable procedure which has some advantages over the conventional preparation with carbimazole and potassium iodide, not the least of which are the potential reduction in preparation time, the more flexible timing of operation, and the reduced operative blood loss.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 041101580

Download citation: RISBibTeXText

PMID: 826544

DOI: 10.1210/jcem-43-6-1312

Related references

Propranolol in thyrotoxicosis: II. Serum thyroid hormone concentrations during subtotal thyroidectomy. Canadian Journal of Surgery. Journal Canadien de Chirurgie 22(3): 264-266, 1979

Subtotal thyroidectomy. A treatment to keep in mind in amiodarone-induced thyrotoxicosis. Revista Espanola de Cardiologia 49(6): 474-476, 1996

Propranolol and thyroidectomy in the treatment of thyrotoxicosis. Annals of Surgery 195(6): 766-773, 1982

Pituitary irradiation prior to subtotal thyroidectomy in the treatment of the thyro-hypophysial syndrome in thyrotoxicosis; a preliminary report. Acta Chirurgica Scandinavica 108(5): 368-374, 1955

Propranolol in thyrotoxicosis. Cardiovascular changes during thyroidectomy in patients pre-treated with propranolol. Anaesthesia 33(6): 535-539, 1978

Recurrent thyrotoxicosis after subtotal thyroidectomy. British Medical Journal 4(5782): 258-261, 1971

Hypocalcemia after subtotal thyroidectomy for thyrotoxicosis. British Journal of Surgery 72(1): 77-77, 1985

Hypocalcaemia after subtotal thyroidectomy for thyrotoxicosis. British Journal of Surgery 71(8): 589-590, 1984

On subtotal thyroidectomy in thyrotoxicosis and malignant exophthalmos. Problemy Endokrinologii i Gormonoterapii 8: 72-75, 1962

LATS and recurrent thyrotoxicosis after subtotal thyroidectomy. Clinical Science 39(3): 10p-10p, 1970

Subtotal thyroidectomy for thyrotoxicosis: a reassessment, including TRH responsiveness. New Zealand Medical Journal 87(607): 163-166, 1978

The effect of remnant size on the outcome of subtotal thyroidectomy for thyrotoxicosis. British Journal of Surgery 59(7): 559-563, 1972

Subtotal thyroidectomy a rational alternative in severe iodine induced thyrotoxicosis. Hall, R And J Koebberling (Ed ) Serono Symposia Publications From Raven Press, Vol 22 Thyroid Disorders Associated With Iodine Deficiency And Excess; Freiburg/Br , West Germany, Apr 24-26, 1984 Xvi+453p Raven Press Books, Ltd : New York, N Y , Usa Illus Maps 435-442, 1985

Long-term critical evaluation of hypothyroidism after subtotal thyroidectomy for thyrotoxicosis. Minerva Medica 67(59): 3871-3880, 1976

Iodine-induced thyrotoxicosis--a case for subtotal thyroidectomy in severely ill patients. Klinische Wochenschrift 63(1): 1-7, 1985