Anesthesia for Transoral Endoscopic Parathyroidectomy by Vestibular Approach (TOEPVA)

Abstract

Introduction: After thyroid diseases, hyperparathyroidism is one of the most common endocrine surgical disease. The increasing diagnosis of thyroid pathologies in early stages and a societal emphasis on physical appearances, especially in young women, have been led to development of new surgical techniques alternative to conventional transcervical incision consistently. Here, we describe our anaesthesia experience for parathyroidectomy with Transoral Endoscopic Parathyroidectomy by Vestibular Approach (TOEPVA). Material-method: Patients undergo TOEPVA at the Health Sciences University Izmir Bozyaka Training and Research Hospital between November 2018 and April 2019 were reviewed. Demographic data and hemodynamic parameters were reported. Seven patients were operated successfully by this technique none of which required conversion to conventional open surgery. Two patient required atropine and one patient required ephedrine during insufflation. Conclusion: After induction of anaesthesia with propofol, remifentanil and rocuronium; anaesthesia managed by desflurane co-administered with continous infusion of remifentanil, provide feasible and safe anaesthesia for TOEPVA. However, especially during hydrodissection and insufflation, a close cooperation between surgeon and anaesthetist have a great value to improve patient management.