A 35-year-old woman with Graves' disease is being prepared for thyroidectomy. She is currently on carbimazole. Which preoperative preparation is SPECIFICALLY given to reduce vascularity of the thyroid gland and reduce intraoperative bleeding?

• A Propranolol — to control heart rate
• B Hydrocortisone — to prevent thyroid storm
• C Selenium supplementation — to reduce oxidative stress
• D Lugol's iodine solution — given for 10 days preoperatively ✓

Explanation

Lugol's iodine solution (potassium iodide + iodine) is given for 10-14 days preoperatively in Graves' disease to reduce thyroid vascularity and firmness — the Wolff-Chaikoff effect temporarily reduces thyroid hormone synthesis, while high iodine causes involution of the gland, making surgery technically easier and reducing intraoperative haemorrhage. Propranolol controls adrenergic symptoms but does not reduce gland vascularity. Carbimazole makes the patient euthyroid but does not replace Lugol's iodine for vascularity reduction.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.