The effect of preoperative Lugol's iodine on intraoperative bleeding in patients with hyperthyroidism

• Preoperative Lugol solution treatment decreased the rate of blood flow, and intraoperative blood loss during thyroidectomy.
• Preoperative Lugol solution treatment was found to be a significant independent determinant of intraoperative blood loss.
• The reduction of intraoperative bleeding allows better visualization and preservation of the surrounding nerves, vasculature, and parathyroid glands.

AimTo investigate the effect of preoperative Lugol's iodine on intraoperative bleeding in patients with hyperthyroidism.Material and methodsThis controlled, randomized, prospective cohort was carried out on 40 patients who admitted for surgery due to hyperthyroidism. Cases were randomly assigned to receive either preoperative treatment with Lugol solution (Group 1) or no preoperative treatment with Lugol solution (Group 2). Group 3 (n = 10) consisted of healthy adults with no known history and signs of hyperthyroidism. Blood flow through the thyroid arteries of patients was measured by color flow Doppler ultrasonography. Free T3, free T4, TSH, thyroid volume and the resistance index of the four main thyroid arteries were measured in all patients.ResultsThere was not a significant difference between gender, preoperative serum thyroid hormone levels, or thyroid gland volumes between groups 1 and 2. The mean blood flow of the patients in Group 1 was significantly lower than values in Group 2. When age, gender, thyroid hormone, TSH, thyroid volume, blood flow, and Lugol solution treatment were included as independent variables, Lugol solution treatment (OR, 7.40; 95% CI, 1.02–58.46; p = 0.001) was found to be the only significant independent determinant of intraoperative blood loss. Lugol solution treatment resulted in a 7.40-fold decrease in the rate of intraoperative blood loss.ConclusionPreoperative Lugol solution treatment was found to be a significant independent determinant of intraoperative blood loss. Moreover, preoperative Lugol solution treatment decreased the rate of blood flow, and intraoperative blood loss during thyroidectomy.