Long-acting beta-adrenergic antagonists as preparation for surgery in thyrotoxicosis

This report describes our experience with 12 patients with thyrotoxic Graves' disease who were prepared for thyroidectomy using only a long-acting orally administered beta-adrenergic blocking agent (nadolol or atenolol); iodides were not used. This form of preparation proved to be very effective, fast acting, and economical. It permitted rapid preparation of patients for surgery and resulted in excellent control of the manifestations of hyperthyroidism in the perioperative period. The surgery was relatively easy and bloodless, and there were no operative complications. We recommend that these long-acting beta-adrenergic blocking agents be considered as the preferred medication for the preparation of thyrotoxic patients for surgery.