Randomized trial of a short course of preoperative potassium iodide in patients undergoing thyroidectomy for Graves' disease

Abstract Background A short course of potassium iodide (SSKI) has been traditionally used to prepare patients with Graves' disease for thyroidectomy. The rationale for this treatment has evolved over time; from control of hyperthyroidism to facilitating surgery by making the gland less friable and bloody. Methods Randomized trial of preoperative SSKI vs no SSKI to test whether that is true. Results Mean estimated blood loss in the SSKI group (62 mL) was less than in the control group (162 mL) as was the median estimated blood loss (50 vs 140 mL). Mean (142 vs 162 minutes) and median (138 vs 150 minutes) operative times were also less in the SSKI arm. Subjective difficulty of operation was similar. Multivariable comparisons of groups with analysis of covariance showed the SSKI group suffered a mean blood loss 35% of the no treatment group ( P = .036), the 9.2% decrease in Operating Room (OR) time between the SSKI group and the no treatment group was not statistically different ( P = .464). Conclusions SSKI given before operation in patients with Graves' disease reduces blood loss during thyroidectomy.