PreOperative Care (Thyroidectomy)

This page is not meant to be an exhaustive review of preoperative care in anticipation of thyroid surgery. General and some specific issues are discussed that are common and important in our patients.

Generally there are few changes that you need to make in your daily routine or health maintenance. If you smoke we recommend stopping for at least a week before the surgery. Smoking causes chronic airway irritation. This could result in excessive coughing after the surgery. This will be uncomfortable for you and could increase the risk of postoperative bleeding or hematoma formation.

The majority of prescribed medication may be continued during the preoperative period. Coumadin, a commonly prescribed blood thinner, should be stopped 4-5 days before surgery. We will discuss this during your office visit. Most other medications including aspirin, plavix and aggrenox may be continued. However, it is important that we know about all your medication including any over the counter medication you may be taking. A written list of your medications with dosages is very helpful.

If you have an overactive thyroid gland, you may need medication pre-op to control it. This is very important for your safety during the operation. These drugs are anti-thyroid medications, usually methimazole or propylthiouracil, and/or a class of drugs called beta-blockers. If you need these drugs, we will prescribe them at your office visit. It generally takes about two weeks for these drugs to have full effect so that the operation can be performed safely.

You ,of course, should make us aware of any chronic medical conditions including any medication allergies you may have. Also, we need to be aware if there is a personal or family history of blood clots or bleeding disorders.

If you are having any voice or swallowing problem, we may need to evaluate these before surgery. We will make that referral if it is required.

Don’t drink or eat anything after midnight the day before your surgery. Any medication you may be taking for your heart or high blood pressure can be taken with a sip of water when you get up that morning. Usually, we do not want you to take your diabetic medication the day of surgery. If you are uncertain about what to do just call us.

If you have significant chronic health problems, you will meet with the anesthesiologist a few days before the surgery. Clarify any questions about your medication with them as well.