**6.6 Pre-operative preparation**

It is mandatory to achieve normal metabolic state before patients undergo thyroid surgery or else patients may land u into thyroid storm. Normal metabolic state is generally achieved by using ATD in appropriate dose and duration. Beta blockers are also used in management to achieve eumetabolism before surgery. Once eumetabolism is achieved SSKI is added, 2–3 drops twice daily, for 7–10 days. Lugol's iodine can also be used depending on its availability.
