Preoperative Preparation with Lugol's Iodine in Thyroidectomy of Euthyroid Patients-Is it Really Mandatory?-An...

To elucidate the necessity of Lugol's iodine in preoperative preparation of patients undergoing thyroidectomy.

Hundred and five euthyroid patients who underwent surgery without preoperative preparation of patients with Lugol's iodine were enrolled in this retrospective study conducted during the period May 2009 to August 2013 in Teaching Hospital. Indication of surgery was ranging from suspected malignancy to cosmetic reasons and compressive features like dysphagia , dyspnoea and hoarseness of voice.

All patients were operated by the same surgeon where in hemi, total and subtotal thyroidectomies were performed without any usage of Lugol's iodine preoperatively. During the postoperative period the following events occurred, five patients (4.7%) had incurred recurrent laryngeal nerve palsy (RLNP) which was confirmed with postoperative indirect laryngoscopic examination and two patients (1.9%) with hypocalcemia (serum calcium less than 8mg/dl) which was managed conservatively and effectively. Among these five patients, three patients had (Right RLNP) and two patients had (Left RLNP) palsies. Of these four RLNP (3.8%) were temporary which improved with conservative management within 3weeks-6months duration and one (0.9%) was a permanent Rt RLNP with no improvement even after six months.

Hence, we conclude that it is not of much importance to use Lugol's iodine preoperatively in patients undergoing thyroidectomy. There does not appear any convincing evidence of advantages of preoperative preparation of patients with lugol's iodine in euthyroid state undergoing surgery.