Seminars: Local and regional anesthesia for thyroid surgery

Arora, Nimmi; Dhar, Panchali; Fahey, Thomas J.

doi:10.1002/jso.20694

Cited by 31 publications

(34 citation statements)

References 17 publications

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“…To decrease the postoperative pain and reduce the need for analgesics following thyroidectomy surgery, preoperative oral controlled-release analgesia with opioids and alternative regional techniques such as incisional local anesthesia, intraoperative bilateral superficial and/or deep cervical plexus block, local wound infiltration with local analgesia have also been suggested recently (20,21,23,(27)(28)(29). Performing thyroidectomy under local or regional anesthesia rather than general anesthesia has also been suggested to control postoperative pain (30).…”

Section: Discussionmentioning

confidence: 99%

Local bupivacaine for postoperative pain management in thyroidectomized patients: A prospective and controlled clinical study

Dumlu¹,

Tokaç²,

Öcal³

et al. 2016

UCD

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Objective: We aimed to evaluate the effect of bupivacaine and to compare the routes of administration of bupivacaine in the management of postoperative incision site pain after thyroidectomy. Material and Methods:Consecutive patients who were planned for thyroidectomy surgery were randomized into three groups of 30 patients each: Group 1 (control group): standard thyroidectomy surgery without additional intervention; Group 2 (paratracheal infiltration with bupivacaine): following thyroidectomy, 0.25% bupivacaine was applied on the surgical area; Group 3 (subcutaneous infiltration with bupivacaine): following thyroidectomy, 0.25% bupivacaine was injected into the cutaneous, subcutaneous region and fascia of the surgical area. Postoperative pain was evaluated by a visual analog scale (VAS) at 1 st , 4 th , and 12 th hours after thyroidectomy. Total daily requirement for additional analgesia was recorded. Results:The mean age of 90 patients was 44.37±13.42 years, and the female:male ratio was 62:28. There was no difference between study groups in terms of age, thyroid volume, TSH and T4 levels. VAS score of patients in paratracheal infiltration with bupivacaine group was significantly lower than control group patients at 1 st , 4 th and 12 th hours following thyroidectomy (p=0.030, p=0.033, p=0.039, respectively). The need for analgesics was significantly lower in both paratracheal infiltration and subcutaneous infiltration groups than the control group (86.7%, 83.0%, and 73.3%, respectively, p=0.049). Conclusions:Intraoperative local bupivacaine application is effective in decreasing postoperative pain in patients with thyroidectomy.

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Section: Discussionmentioning

confidence: 99%

Local bupivacaine for postoperative pain management in thyroidectomized patients: A prospective and controlled clinical study

Dumlu¹,

Tokaç²,

Öcal³

et al. 2016

UCD

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“…When methods applied by adding bilateral deep cervical plexus block to BSCPB without general anaesthesia were examined, it was observed that patients are discharged from hospital much earlier with this method, however patients should be selected very carefully in terms of surgical procedures, general conditions of patients and anxiety, otherwise both patient and surgeon comfort grow worse (15)(16)(17).…”

Section: Discussionmentioning

confidence: 99%

Genel anestezi altında yapılan troid cerrahisinde bilateral yüzeyel servikal blok uygulamasının postoperatif analjezi üzerine etkisi

Çanakçı¹,

Taş²,

Yağan³

et al. 2015

Ege Tıp Dergisi

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Aim: The purpose of this study was to assess the effect of bilateral superficial cervical plexus block (BSCPB), administered along with general anesthesia in total thyroidectomy surgical operations, on postoperative opioid consumption and the duration of hospital stay. Materials and Methods:A total of 150 patients who underwent total thyroidectomy surgical operations under general anesthesia and had or did not have bilateral superficial cervical plexus blockade (BSCPB), were prospectively evaluated in terms of their postoperative tramadol needs and durations of hospital stay. At the beginning of the surgical intervention after anesthesia induction, 75 patients who received BSCPB administered with a 0.5% of 20 mL levobupivacaine constituted the BSCPB group; on the other hand, 75 patients in the control group received only general anesthesia and no BSCPB was administered. Results: No statistically significant difference was found when age, gender, height, weight and ASA (American Society of Anesthesiologists) physical status classifications of patients in both groups were compared. Only 15 patients out of 75 patients in the BSCPB group (20%) had postoperative opioid needs, whereas this rate was determined as 85% in 64 patients out of 75 patients in the control group (p<0.05). Similarly, the tramadole consumption in the BSCPB group was significantly less when compared to the control group (p<0.05). Postoperative hospital stay in the BSCPB group (2.4±0.6) was also significantly less than that of the control group (4.7±1.6) (p<0.05) Conclusion: Bilateral superficial cervical plexus block administered along with general anesthesia in thyroidectomy operations considerably reduces pain and tramadol need in the postoperative period and lessens the duration of hospital stay.Keywords: Thyroidectomy, superficial cervical plexus block, opioid. Öz Amaç: Total tiroidektomi operasyonların da genel anesteziye ek olarak uygulanan bilateral yüzeyel servikal pleksus bloğu (BYSPB)'nun postoperatif opioid tüketimi ve hastanede yatış süresine etkisini değerlendirmeyi amaçladık. Gereç ve Yöntem: Genel anestezi altında total tiroidektomi operasyonu geçiren, bilateral yüzeyel servikal pleksus blokajı (BYSPB) yapılan ve yapılmayan toplam

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“…Generally, local anesthesia without cervical plexus block is limited to central thyroid resections, for example isthmusectomy. Although more extensive thyroid resections can be performed under strict local anesthesia, adjuvant cervical plexus blocks facilitate deeper dissection and reduce the need for repeated injections of local anesthetic during the operation [15].…”

Section: Local Anesthesia and Cervical Plexus Blockmentioning

confidence: 99%

“…Alone or in combination, lidocaine and bupivacaine are excellent choices; such combinations of short and longer-acting anesthetic agents can be supplemented with epinephrine (1:100,000 or 1:200,000) to prolong the duration of the anesthetic [13,15,17]. The cervical nerve block may be executed by the anesthesiologist or surgeon before the patient enters the operating room, or by the surgeon just before making the incision.…”

Section: Local Anesthesia and Cervical Plexus Blockmentioning

confidence: 99%

Thyroidectomy Under Local Anesthesia

Milan

Sosa

2013

Curr Surg Rep

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Thyroidectomy under local anesthesia was common historically. With improvements in general anesthesia, local anesthesia techniques are now restricted to patients deemed too ill to undergo general anesthesia or to those who live in extremely resource-poor locations. In the last few decades there has been renewed interest in thyroidectomy under local anesthesia, and the few published series reveal morbidity outcomes are equivalent to those for thyroidectomy under general anesthesia. Limited data on the cost of the procedure indicate thyroidectomy under local anesthesia is cost-effective.

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Seminars: Local and regional anesthesia for thyroid surgery

Abstract: Local and regional anesthesia is safe and well tolerated for the majority of thyroid surgery.

Cited by 31 publications

References 17 publications

Local bupivacaine for postoperative pain management in thyroidectomized patients: A prospective and controlled clinical study

Local bupivacaine for postoperative pain management in thyroidectomized patients: A prospective and controlled clinical study

Genel anestezi altında yapılan troid cerrahisinde bilateral yüzeyel servikal blok uygulamasının postoperatif analjezi üzerine etkisi

Thyroidectomy Under Local Anesthesia

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