Since Plummer1 in 1923 introduced Lugol's solution for the treatment of exophthalmic goiter, iodine has been a routine agent in the preoperative management of these patients. However, in spite of its proper use there still remains a group of cases in which there is serious surgical risk. These patients are very toxic, having had the disease a long time. A large thyroid gland and a high basal metabolic rate usually are present. Widespread visceral strain is evident, as shown by great weight loss and at times cardiac complications. Preoperative improvement of these patients beyond the state obtained by the use of Lugol's solution and the usual supportive measures is desirable, but until recently no effective measures were available. Therefore these patients continued to cause the physician anxiety during the forty-eight hour postoperative period, and many of them required multiple stage operations to avoid severe reactions.
Recently a new group
BARTELS EC. THIOURACILITS USE IN THE PREOPERATIVE MANAGEMENT OF SEVERE HYPERTHYROIDISM PRELIMINARY REPORT. JAMA. 1944;125(1):24–26. doi:10.1001/jama.1944.02850190026008
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