ISSN: 2961 - 4295
Effect of Preoperative Lugol’s Iodine on Intraoperative Blood Loss in Thyroidectomy in Euthyroid Patients: A Systematic Review and Meta-Analysis
Abdel-Sattar Elshory¹, Fakhry Sanhory², Salma Ismail², Qasem Elotiby¹
Background: 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.
A 50-Year-Old Female with Hypertension Revealing Cushing’s Disease: A Case Report.
Khaled Mejahed¹, Abdel-Qader Fakhr¹, Khalid Salman², Salma Emad¹, Ayham F. Reweey²
Hypertension is a common condition frequently managed in primary care. However, secondary causes such as Cushing’s syndrome may be overlooked, leading to delays in diagnosis and treatment. We present the case of a 50-year-old female with a 5-year history of hypertension who presented for routine medication adjustment. A systematic clinical assessment revealed features suggestive of hypercortisolism. Subsequent biochemical testing confirmed Cushing’s disease, and MRI imaging revealed a pituitary adenoma with associated visual field defects, previously unnoticed by the patient. This case highlights the importance of comprehensive evaluation in hypertensive patients to identify secondary causes and prevent complications.
