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Updated: May 12, 2026
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Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy
Published on: October 24, 2025
Risk factors for intraoperative hypotension during thyroid surgery.
Nevena Kalezic1, Marina Stojanovic, Nebojsa Ladjevic
1Faculty of Medicine, University of Belgrade, Belgrade, Serbia and Centre for Endocrine Surgery, Clinical Centre of Serbia, Belgrade, Serbia. casopis.anestezija@gmail.com
Summary
Intraoperative hypotension (IOH) occurred in 6.5% of thyroid surgery patients. Younger patients with lower BMI and no hypertension were more prone to IOH, which increased the risk of postoperative hypotension.
Area of Science:
- Anesthesiology
- Surgical Outcomes
- Cardiovascular Physiology
Background:
- Intravenous anesthetics frequently cause hypotension, particularly during anesthesia induction.
- Intraoperative hypotension (IOH) is a significant concern in surgical settings.
- Thyroid surgery presents unique challenges regarding hemodynamic stability.
Purpose of the Study:
- To determine the incidence of intraoperative hypotension (IOH) in patients undergoing thyroid surgery.
- To identify risk factors associated with IOH in this patient population.
- To assess the impact of IOH on the occurrence of postoperative hypotension.
Main Methods:
- A retrospective study of 1252 euthyroid patients (ASA 2-3) undergoing thyroid surgery (2007-2011).
- IOH defined as a >20% decrease in systolic blood pressure from baseline.
- Logistic regression analysis used to identify predictors of IOH, considering demographics, comorbidities, and surgical factors.
Main Results:
- IOH was observed in 6.5% of patients, with thyroidectomy being the most common procedure.
- Younger patients, those with lower body mass index (BMI), and without hypertension were more likely to experience IOH.
- Independent predictors for IOH included lower BMI and the absence of hypertension.
- Patients with IOH had a significantly higher incidence of postoperative hypotension (9.9% vs. 2.4%).
Conclusions:
- Intraoperative hypotension is a common complication in thyroid surgery, even with short procedures and minimal bleeding.
- Patients experiencing IOH require heightened vigilance due to an increased risk of subsequent postoperative hypotension.
- Proactive management strategies are crucial to mitigate the risks associated with IOH in thyroid surgery patients.
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