PROGNOSIS OF CARDIAC COMPLICATIONS IN ENDOCRINE SURGERY

Аннотация

Thyroid disorders rank among the most prevalent conditions in endocrinology. Cardiovascular complications associated with these disorders not only impair patients' quality of life but also substantially elevate the risk of adverse surgical outcomes, with surgery being the primary definitive treatment. Consequently, many researchers in scientific literature regard both existing and emerging thyrotoxicosis as contraindications for elective thyroid surgery. Recent advancements have significantly broadened the scope of anesthesiological techniques employed during thyroid gland procedures. This article evaluates the preoperative preparation of patients with toxic and non-toxic goiter, as well as their management during the perioperative period. Keywords: thyroid gland, toxic goiter, non-toxic goiter, thyrotoxicosis, premedication, analgesics, ketamine, narcotic analgesics, sevoflurane, xenon. According to the World Health Organization, more than 300 million people worldwide are infected with endemic goiter, which is 7% of the world's population. Diffuse non-toxic and nodular goiter occupies an important place in the structure of morbidity of the population and is second only to diabetes in terms of frequency of occurrence among endocrine diseases [4]. The prevalence of nodular and mixed goiters in the population is 21%, and all of them require surgical treatment [3,4]. There have been no cases of decrease in the high rates of the disease. In the last 10 years, thyroid gland surgery has significantly developed abroad and in our country. The effectiveness of the treatment of diffuse nontoxic and nodular goiter, including thyroid pathology, with drugs and surgery, has been substantiated by many studies, in which the metabolism and mechanism of action of thyroid hormone biosynthesis, as well as toxic goiter, has been studied [5]. Although significant progress has been made in the field https://scientific-jl.org/obr 5 1 5 Выпуск журнала №-70 Часть–8_ июня –2025 ОБРАЗОВАНИЕ НАУКА И ИННОВАЦИОННЫЕ ИДЕИ В МИРЕ 2181-3187 of anesthesia of patients with diffuse non-toxic and nodular goitre, it is observed that there are complications during the operation and in the postoperative period with possible blood circulation disorders. Detection of obvious changes in the cardiovascular system reduces the effectiveness of surgical treatment. According to the research of Russian scientists, postoperative complications of patients with such pathology were 1-4% [2], according to the data of foreign researchers, 5-10% [1]. There are no clearly developed data on diffuse non-toxic and nodular goitre in the preoperative period. It is known that many complications were observed in the period before receiving iodine, that is, when the operation was performed without special preparation, during the operation and in the postoperative period [5]. Combined preoperative preparation has been used for many years, resulting in a significant reduction in early postoperative complications. Complications observed as a result of the use of thyrostatic drugs in patients with diffuse toxic goiter: increased blood pressure, monitoring of arrhythmias, use of iodine therapy and antiarrhythmic drugs, as well as cardiac glycosides to prevent excessive bleeding [7]. On the other hand, preoperative preparation is important for surgical treatment of patients with diffuse nontoxic and nodular goiter. Due to the high risk of developing postoperative complications in patients with partial symptoms of thyrotoxicosis who are not properly prepared, it is dangerous to operate on this group of patients. Proper systematic preoperative preparation reduces the likelihood of postoperative complications. Purpose of work Analysis of preoperative preparation methods in patients with thyroid diseases (diffuse nontoxic and nodular goiter) and evaluation of their effectiveness. Inspection materials and methods The study was conducted in the departments of surgery, anesthesiology and resuscitation of the multidisciplinary clinic of the Samarkand State Medical University. 110 patients were taken for examination: shortness of breath due to the size of the https://scientific-jl.org/obr 5 1 6 Выпуск журнала №-70 Часть–8_ июня –2025 ОБРАЗОВАНИЕ НАУКА И ИННОВАЦИОННЫЕ ИДЕИ В МИРЕ 2181-3187 thyroid gland, which was present in all patients, MNS function (responsibility, headache, decreased work ability, sleep disturbance), cardiovascular system (palpitations, rapid heart rate, expansion of heart borders) signs of deterioration, signs of diffuse damage to the myocardium (on ECG), as well as damage to the digestive system changes such as weight loss, increased or decreased appetite, etc. All patients underwent complete clinical and diagnostic examination, necessary paraclinical and biochemical examinations. All patients underwent thyroid palpation, thyroid ultrasound examination (UTT), and general clinical examinations that determined the amount of thyrotropin hormone. The examined patients w