propylthiouracil and Hypocalcemia

From March 1980 to August 1982, 108 patients with Graves' disease participated in a prospective study at Yonsei University College of Medicine. Preoperatively, 22 patients were prepared with propranolol alone (group 1) and 86 with propranolol and propylthiouracil (PTU) (group 2). The duration of preparation averaged 11.5 days for group 1 and 10.8 days for group 2. Bilateral subtotal thyroidectomy was performed, leaving 4 to 6 grams at both upper poles. No significant difference was noted in the average weight of the removed gland or the amount of blood loss between both groups. During the operation, the pulse rate of group 1 was significantly faster than that of group 2 but evened out by the day of discharge. The incidence of high fever during and immediately after operation was 27.3 per cent in group 1 which is greater than the 17.4 per cent in group 2. In group 1, the incidence of postoperative transient hypocalcemia was 27.3 per cent, transient or prolonged hypothyroidism was 13.6 per cent and recurrence of thyrotoxicosis was 4.5 per cent. In group 2, the values were 22.1, 18.6 and 4.7 per cent, respectively. High fever developed in one patient from group 1 during operation and this patient died on the third day postoperatively. From the results of our study, it appears to be more beneficial to administer both propranolol and PTU as preoperative medication to patients with Graves' disease prior to undergoing operation.

Topics: Adult; Clinical Trials as Topic; Drug Therapy, Combination; Female; Fever; Follow-Up Studies; Graves Disease; Humans; Hypocalcemia; Male; Postoperative Complications; Premedication; Preoperative Care; Propranolol; Propylthiouracil; Prospective Studies; Pulse; Random Allocation; Thyroidectomy; Time Factors

Topics: Adult; Agranulocytosis; Female; Humans; Hyperthyroidism; Hypocalcemia; Propylthiouracil

From 1959 to 1970, 272 operations for thyrotoxicosis were performed. Most of the patients received anti-thyroid drugs and thyroid hormones preoperatively. The patients were continuously followed up. The primary results with low morbidity and no mortality as well as the long term results with a low rate of recurrence and a relatively high incidence of thyroid substitution are discussed. A safe and effective programme for surgical treatment of thyrotoxicosis is described. Anti-thyroid drugs and thyroid hormones should be administered as the method of choice in preparing these patients for surgery.

Topics: Adolescent; Adult; Aged; Antithyroid Agents; Carbimazole; Child; Female; Goiter; Humans; Hyperthyroidism; Hypocalcemia; Hypothyroidism; Laryngoscopy; Length of Stay; Male; Methimazole; Middle Aged; Paralysis; Postoperative Complications; Preoperative Care; Propylthiouracil; Recurrent Laryngeal Nerve; Thyroxine; Triiodothyronine

Topics: Adolescent; Child; Female; Graves Disease; Humans; Hyperthyroidism; Hypocalcemia; Laryngeal Edema; Male; Methimazole; Methods; Postoperative Complications; Potassium Iodide; Propranolol; Propylthiouracil; Thyroid Hormones; Thyroidectomy

Topics: Adult; Aged; Analysis of Variance; Antithyroid Agents; Calcitonin; Calcium; Female; Graves Disease; Humans; Hyperthyroidism; Hypocalcemia; Middle Aged; Phosphates; Propylthiouracil; Thyroid Gland; Thyroidectomy; Thyroiditis