ALTERED ENDOCRINE RESPONSE TO PARTIAL THYROIDECTOMY IN PROPRANOLOL-PREPARED HYPERTHYROID PATIENTS

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Abstract
The endocrine response to partial thyroidectomy in a group of 20 hyperthyroid patients prepared with propranolol alone was compared to that of a matched control group of 10 euthyroid patients. In propranolol-prepared patients, the glucose response to surgery was reduced (P < 0.05) for up to 4 h postoperatively and biochemical hypoglycemia was noted in 1 patient. Both thyroxine and triiodothyronine (T3) fell significantly, associated with a marked rise in reverse T3. Growth hormone levels were higher (P < 0.05) both pre- and postoperatively in propranolol-prepared patients, whereas prolactin levels, although similar preoperatively, were lower (P < 0.05) in these patients postoperatively. Cortisol and ACTH levels were lower (P < 0.05) both before and following thyroidectomy in propranolol-prepared patients. The endocrine response to surgical stress is markedly altered in propranolol-prepared hyperthyroid patients.