[Value of high dosage propranolol and per-operative hypothermia in thyroidectomy when conventional preparatory treatment is unsuitable (author's transl)].
Five hyperthyroid patients could be prepared for surgery wit propranolol alone in daily doses of 240 to 400 mg. The drug administered for 3 to 5 days before, and 5 to 15 days after the operation. Following premedication with levopromazine, almost total thyroidectomy was performed under neuroleptanalgesia and moderate hypothermia. The immediate results were satisfactory and free from acute thyrotoxic crisis. On follow-up, 2 to 18 months after surgery 4 patients had clinically and biologically normal thyroid function, and one patient showed evidence of hypothyroidism. For the common forms of the disease the authors use the conventional preparatory treatment. However, they favour a short course of propranolol in high doses either when non-thyroid emergency operations require preliminary treatment of the patient's hyperthyroidism, or when the conventional treatment is ineffective or contra-indicated on account of haematological complications.
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006980:Hyperthyroidism / Q000188:drug therapy / Q000601:surgery*; D007036:Hypothermia, Induced; D008297:Male; D008875:Middle Aged; D011292:Premedication; D011433:Propranolol / Q000627:therapeutic use*; D013965:Thyroidectomy
D011433:Propranolol
Echec ou insuffisance de la préparation médicale conventionnelle à la chirurgie de l'hyperthyroïdie. Intérêt du propranolol à forte dose et de l'hypothermie modérée peropératoire.