dawnmedDawnMed Journal of Medical ScienceISVolume 2, Issue 1MultidisciplinaryEnglish2026NNY20250513General SurgeryEffect of Preoperative Lugol’s Iodine on Intraoperative Blood Loss in Thyroidectomy in Euthyroid Patients: A Systematic Review and Meta-AnalysisEnglishY511Abdel-SattarElshory¹EnglishNFakhrySanhory²EnglishYSalmaIsmail²EnglishYQasemElotiby¹EnglishYBackground: Although Lugol’s iodine is routinely used in hyperthyroid patients before thyroidectomy to reduce gland vascularity, its role in euthyroid patients remains controversial. Aim: This study aims to evaluate the effectiveness of Lugol’s iodine in reducing intraoperative blood loss in euthyroid patients undergoing thyroidectomy.Methods: A systematic search of PubMed, Embase, Web of Science, and Scopus was performed up to May 2025. Randomized controlled trials (RCTs) comparing preoperative Lugol’s iodine to placebo or no intervention in euthyroid patients were included. The primary outcome was intraoperative blood loss. Meta-analysis was conducted using a random-effects model, with mean difference (MD) and 95% confidence intervals (CI).Results: Out of 487 screened records, 3 RCTs with 250 euthyroid patients (125 Lugol’s, 125 control) were included. Lugol’s iodine significantly reduced intraoperative blood loss compared to control (MD: –18.22 mL, 95% CI: –21.53 to –14.92; p < 0.00001). Moderate heterogeneity was observed (I² = 85%). All included studies had moderate-to-high methodological quality. No consistent data on adverse effects were reported.Conclusion: Preoperative Lugol’s iodine significantly reduces intraoperative blood loss in euthyroid patients undergoing thyroidectomy. While findings support its use as a blood-conserving adjunct, further large-scale trials with standardized protocols are warranted to confirm efficacy and assess safety.EnglishLugol’s iodine, thyroidectomy, euthyroid, intraoperative blood loss, randomized controlled trials, iodine preparation.https://dawnmed.com.sa/abstract?id=3References1619Smith J, Al-Mutairi K, Johnson P. Surgical challenges in thyroidectomy: bleeding complications and management. J Surg Res. 2018;224:120-6.Ahmed H, Al-Zahrani S. Impact of intraoperative bleeding on thyroid surgery outcomes: a retrospective study. Saudi Med J. 2019;40(2):155-60.Lee WY, Kim YJ, Park SH. Preoperative iodine preparation in hyperthyroid patients: a meta-analysis. Endocr J. 2017;64(1):1-9.Al-Ghamdi M, Farouk O, Hussein W. Efficacy of Lugoland;rsquo;s iodine in reducing thyroid gland vascularity in Gravesand;rsquo; disease. Int J Surg. 2020;72:15-21.Wolff J, Chaikoff IL. Plasma inorganic iodide as a homeostatic regulator of thyroid function. J Biol Chem. 1948;174(2):555-64.Tanaka K, Yamashita S. Mechanisms of iodine therapy in thyroid disorders. Thyroid Res.2015;8(3):45-52.Patel N, Singh R. Use of Lugoland;rsquo;s iodine in euthyroid patients undergoing thyroidectomy: current perspectives. World J Surg. 2021;45(9):2735-42.Al-Qahtani A, Al-Saleh M. Preoperative preparation for thyroidectomy in euthyroid patients: a systematic review. Ann Saudi Med. 2022;42(5):321-7.Zhao L, Chen M, Wu J. Effect of preoperative Lugoland;rsquo;s iodine on blood loss in euthyroid patients: a randomized controlled trial. Thyroid. 2019;29(8):1154-60.Al-Harbi S, Al-Mutairi A, El-Badawi O. Comparison of Lugoland;rsquo;s iodine versus placebo in reducing intraoperative bleeding during thyroidectomy. Saudi J Med Med Sci. 2020;8(3):186-91.Williams D, Thompson G, Harrison P. Preoperative iodine administration in euthyroid thyroidectomy patients: a randomized trial. J Endocr Surg. 2021;14(2):98-104.Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi:10.1136/bmj.n71El-Hadi M, AlZahrani A, Khan M. Preoperative use of Lugoland;rsquo;s iodine in thyroidectomy for euthyroid patients: a randomized trial. Saudi Med J. 2020;41(6):602-608.Erbil Y, Barbaros U, Ozarmağan S, et al. Effect of Lugol solution on thyroid gland blood flow and microvessel density in patients with Gravesand;rsquo; disease. World J Surg. 2007;31(5):1005-1011.Katagiri M, Saito S, Igarashi A. Vasoconstrictive effects of iodine solutions on thyroid blood flow: clinical implications for thyroid surgery. Surg Today. 2011;41(4):511-515.Braverman LE. Iodine-induced thyroid dysfunction. In: Braverman LE, Cooper DS, eds. Werner and;amp; Ingbarand;#39;s The Thyroid: A Fundamental and Clinical Text. 10th ed. Lippincott Williams and;amp; Wilkins; 2013. p. 270-280.Wang Y, Wang C, Zhang L. Preoperative iodine solution in reducing intraoperative bleeding in thyroidectomy: a meta-analysis. Int J Surg. 2022;94:106142.Henning J, Modrzejewski A, Kubiak R, et al. Preoperative iodine and surgical outcome in thyroidectomy: systematic review. Eur Arch Otorhinolaryngol. 2023;280(1):15-22.Lee J, Park H, Kim S. Safety profile of Lugoland;rsquo;s iodine administration in euthyroid patients: a prospective observational study. J Thyroid Res. 2023;2023:6731254.Ma J, Wang X, Zhang Y. Lugoland;rsquo;s iodine as a hemostatic agent in thyroid surgery: impact on operative field and complication rates. Surg Pract. 2024;28(1):22-27.