Perioperative preparation for endocrine disorders and management of patients in intensive care units: Medical education

Abstract

Propylthiouracil or methimazol combined with ss-blockers is a safe way of rapid preoperative preparation for uncontrolled hyperthyroidism. The use of iodide, glucocorticoids, iopanoic acid, lithium, colestiramine, plasmapheresis may be required for rapid preparation in some circumstances. Subclinical hypothyroidism and subclinical hyperthyroidism does not increase the risk of anesthesia. However, euthyroidism should be obtained in overt hypothyroidism and hyperthyroidism to decrease the anesthesia risk. Emergent surgery should not be postponed in hypothyroid patients. Hypothalamic-pituitary-adrenal axis (HPA) should be evaluated in hypocortisolemic patients and perioperative glucocorticoid coverage in the patients with known or suspected HPA suppression must be planned.