Combination of minimally invasive thyroid surgery and local anesthesia associated to iopanoic acid for patients with amiodarone-induced thyrotoxicosis and severe cardiac disorders: a pilot study.

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  • Additional Information
    • Source:
      Publisher: Springer-Verlag Country of Publication: Germany NLM ID: 9808285 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1435-2451 (Electronic) Linking ISSN: 14352443 NLM ISO Abbreviation: Langenbecks Arch Surg Subsets: MEDLINE
    • Publication Information:
      Original Publication: Berlin : Springer-Verlag, c1998-
    • Subject Terms:
      Anesthesia, Local* ; Autonomic Nerve Block*; Amiodarone/*toxicity ; Anti-Arrhythmia Agents/*toxicity ; Goiter, Nodular/*chemically induced ; Goiter, Nodular/*surgery ; Heart Diseases/*complications ; Heart Diseases/*drug therapy ; Iopanoic Acid/*administration & dosage ; Minimally Invasive Surgical Procedures/*methods ; Thyroidectomy/*methods ; Thyrotoxicosis/*chemically induced ; Thyrotoxicosis/*surgery ; Video-Assisted Surgery/*methods; Aged ; Amiodarone/therapeutic use ; Anti-Arrhythmia Agents/therapeutic use ; Arrhythmias, Cardiac/complications ; Arrhythmias, Cardiac/drug therapy ; Cardiomyopathy, Dilated/complications ; Cardiomyopathy, Dilated/drug therapy ; Female ; Goiter, Nodular/blood ; Health Status Indicators ; Heart Failure/complications ; Heart Failure/drug therapy ; Humans ; Male ; Middle Aged ; Myocardial Infarction/complications ; Myocardial Infarction/drug therapy ; Premedication ; Thyrotoxicosis/blood ; Thyroxine/blood ; Triiodothyronine/blood
    • Abstract:
      Background and Aims: Amiodarone-induced thyrotoxicosis is a life-threatening condition. A prompt control of thyrotoxicosis is obtained by thyroidectomy. Preparation with iopanoic acid proved to be very effective in reducing cardiovascular complications. Nevertheless, general anesthesia and extensive surgery may affect negatively patients also after adequate preparation. Safety and efficacy of minimally invasive video-assisted thyroidectomy performed under regional anesthesia (bilateral modified deep cervical block) in patients with amiodarone-induced thyrotoxicosis was evaluated.
      Patients and Methods: Eight patients with amiodarone-induced thyrotoxicosis (three with type I and five with type II), mean age 66.2 years, were prepared with iopanoic acid. There were five men and three women. Three patients had dilatative cardiomyopathy, three had heart failure secondary to severe myocardial infarction, and two had refractory unstable rhythm disorders.
      Results: Minimally invasive video-assisted thyroidectomy was performed under regional anesthesia. Mean operative time was 55.5 min. During surgery, lung and heart function remained well and no surgical complications occurred. After surgery, all patients remained on amiodarone therapy and two patients were subsequently removed from the checklist for heart transplantation.
      Conclusion: Minimally invasive video-assisted thyroidectomy under regional anesthesia can be proposed as resolution of amiodarone-induced thyrotoxicosis in high risk patients with severe cardiac disorders, after preparation with iopanoic acid.
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    • Accession Number:
      0 (Anti-Arrhythmia Agents)
      06LU7C9H1V (Triiodothyronine)
      FE9794P71J (Iopanoic Acid)
      N3RQ532IUT (Amiodarone)
      Q51BO43MG4 (Thyroxine)
    • Publication Date:
      Date Created: 20061115 Date Completed: 20090511 Latest Revision: 20181113
    • Publication Date:
      20250114
    • Accession Number:
      10.1007/s00423-006-0112-y
    • Accession Number:
      17103224