Beta-blockers and the thyrotoxic patient for thyroid and non-thyroid surgery: A clinical review

Abstract

Introduction Thyrotoxic patients presenting for surgery should ideally be biochemically and clinically euthyroid. This is conventionally achieved through the use of anti-thyroid drugs, beta-block-er therapy and iodine. However, there are some circumstances where anti-thyroid drugs may not be a viable option. The implications of this scenario are not widely reported in the literature. This clinical review looks at the evidence on the safety of beta-block-er therapy without the use of anti-thyroid drugs in the preparation of the thyrotoxic patient for surgery. We also highlight key points in the patho-physiology of thyrotoxicosis and the management goals of these patients.