Local Anesthesia in Thyroid Surgery - Own Experience and Literature Review

Abstract

The local anesthesia in thyroid surgery is rarely used, only in selected patients. Majority of centers performing thyroid surgery with local anesthesia have possibility to convert to the general anesthesia. the aim of the study was to present our experiences with partial thyroidectomy under local anesthesia performed in 49 consecutive subjects in the Central African Republic (bilateral subtotal strumectomy, total resection of the one lobe, subtotal resection of the one lobe). Material and methods. All admitted patients with clinically significant goiter were accepted for surgical treatment. For infiltration anesthesia 1% lignocaine was used. Because of the shortage of medical resources, potential conversion to the general anesthesia was impossible. Before the operation patients had received an oral sedation and antibiotic. In 16 patients general anesthesia was used, in other 33 it was impossible. Results. Subtotal bilateral thyroidectomy was performed in 37 patients, 12 patients underwent lobectomy or partial lobectomy of the affected portion of the gland. There were no intraoperative and postoperative complications noticed in the reported group, including complications related to laryngeal nerve injury. The mean duration of the procedure was 127 minutes and mean medical follow-up was 3 days. General condition of all patients on the day of discharge from hospital was good. conclusions. Surgery for goiter under local anesthesia may be a safe alternative where general anesthesia is not available or contraindicated for medical reasons. The infiltration anesthesia is simple to perform and reduces the number of complications potentially occurred at the C2-C4 neck plexus block.

Thyroid Surgery under Local Anaesthesia: Study of 30 Cases

“…Under local anaesthesia complication of general anaesthesia like hazards of endotracheal complication, side effects of anaesthetics, injury to recurrent laryngeal nerve can be avoided. Injury to recurrent laryngeal nerve can be avoided by voice monitoring during operation under local anesthesia as well as cardiac changes 4,11 .…”

“…Local anaesthesia avoids complication of general anaesthesia like nausea, vomiting in post operative period, causes rapid recovery from the operation 3 . Local anaesthesia is cost effective, easy to administer, less hospital stay and less complication 4 . Many studies reported thyroidectomy under local anaesthesia where general anaesthesia had high risk.…”

Thyroidectomy Under Local Anesthesia

“…Thus surgeons started reverting towards regional anesthesia for thyroidectomy as it offered more safety, fast postoperative recovery and minimum hospital stay. 8 Many international studies reported that patients at high risk from general anesthesia underwent successful thyroidectomy under local anesthesia with minimum postoperative complications. Keeping in view the significance and advantages of local versus general anesthesia, for the last one decade the idea to use localized anesthesia for thyroid surgeries has been continuously revisited.…”

The outcome of short stay thyroidectomy in rural medical outreach settings in Northern Nigeria

“…[25][26][27] Furthermore, thyroidectomy under local anesthesia has been shown to be safe and effective in resource-poor settings with limited facilities for general anesthesia. [28][29][30][31] There was also no case of symptomatic hypocalcemia in the series, though some other studies showed hypocalcemia to be the most common morbidity post thyroidectomy. 7,[32][33][34] Zero incidence of hypocalcemia may have been due to the very few cases of total thyroidectomy in the study.…”