Effects of Surgical Stress on Thyroid Function in Man

Abstract

The influence of surgical stress on the human thyroid after head and neck operations was studied by measurements of the early accumulation of radioiodide in the thyroid and by determinations of PBI¹³¹ - and PBI-levels before and after operation. Studying 21 patients it could be shown that after severe surgical stress the I¹³¹-uptake in the thyroid was decreased up to 48 hours. After slighter operations under local or general anesthesia the I¹³²-uptake was unchanged during the first six hours but increased thereafter from the 1st-7th postoperative day with its maximum on the 3rd and 4th days.

The PBI¹³¹-levels showed an approximately daily increase of about 0.013 % with no significant difference between 14 operated and 11 control cases during the 11 days of observation. In the operated group, however, a rapid secretion of PBI¹³¹ after surgical trauma could be observed, followed by decreased hormone secretion. The PBI¹³¹-level after the first four postoperative hours comprised half the total increase of the following two days. The difference from the controls was not significant but this may be because no patient underwent severe operation. Nor was any difference observed between patients operated under local and under general anesthesia.

The PBI-levels of 16 operated patients showed a slight decrease 6–12 days after operation, but no difference between cases with local and with general anesthesia.