Experience with the use of propranolol in the surgical management of thyrotoxicosis

A review of the preoperative preparation of 47 patients undergoing subtotal thyroidectomy for thyrotoxicosis was carried out to evaluate the role of propranolol hydrochloride. Based on the premise that subtotal thyroidectomy is performed at least risk in the patient who is euthyroid, propranolol has its primary role as an adjunct to preparation with thioamide drugs. The most common indications for its use are inadequate control with thioamides and drug toxicity. Less frequent indications are its use in pregnant patients and patients who cannot be relied on to comply with a medical regimen outside the hospital environment. Patients can safely be treated preoperatively in the hospital in a reasonable period of time. When propranolol is used without thioamide drugs, the addition of Lugol's solution is of value in control of the thyrotoxicosis.