From: GRADE-ADOLOPMENT of hyperthyroidism treatment guidelines for a Pakistani context
Original Recommendation | If surgery is chosen as treatment for GD, patients should be rendered euthyroid prior to the procedure with ATD pretreatment, with or without beta-adrenergic blockade. A potassium iodide containing preparation should be given in the immediate preoperative period (Strong Recommendation; Low Quality Evidence). | |||
Modified Recommendation | If surgery is chosen to manage thyrotoxicosis, patients should be rendered euthyroid prior to the procedure with ATD pre-treatment and/or beta-adrenergic blockade. A KI-containing preparation should be given in the immediate preoperative period. | |||
Overall Conclusion | ||||
☐Strong recommendation for Modified Recommendation | ☐Conditional recommendation for Modified Recommendation | ☐Conditional recommendation for either Original Recommendation or Modified Recommendation | ☐Conditional recommendation for Original Recommendation | ☒Strong recommendation for Original Recommendation |
Additional Suggestions: • Potassium iodide should be administered one hour after ATD to prevent iodine being used as substrate for further thyroid hormone synthesis | ||||
Justification: • Rendering a patient euthyroid prior to surgery is essential. Potassium iodide helps achieve euthyroid status while also providing additional potential benefits such as decreasing thyroid vascularity and limiting intraoperative bleeding. |