General and regional anaesthesia for the thyroidectomy in rural/semi-urban Nigerian centres

Musa, A.A.; Lasisi, O.A.; Fatungase, OM; Oyegunle, O

doi:10.4314/eamj.v86i6.54141

Cited by 5 publications

(9 citation statements)

References 26 publications

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“…[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.…”

Section: Discussionmentioning

confidence: 99%

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

2020

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Background: The practice of short stay thyroidectomy is relatively new in developing nations like Nigeria. The primary reason for this is a lack of resources. Furthermore, the prevailing poverty prevents many patients from accessing tertiary health care, as such, ad hoc medical outreaches are usually conducted to bridge the gap. Thyroidectomies have not been routinely performed in these outreach settings due to safety concerns. The study seeks to analyse whether short stay thyroidectomy can be safely practiced under medical outreach settings with limited resources.Methods: The study is a prospective review of all patients that had short stay thyroidectomy at four rural medical outreach settings in Nigeria. Entire study spanned January 2019 to November 2019. Each outreach lasted one week, and patients were followed up for the duration of the outreach. All patients presenting at the outreach locations and diagnosed with goiters who have had no prior neck surgeries, are euthyroid, have no locally advanced malignancies or intrathoracic goiters, have adequate social support, possess a telephone, and have accommodation within the local government area where the outreach is carried out were included in the study. Exclusion criteria included patients who did not satisfy any of the above listed inclusion criteria. Thyroidectomy was done through a standard cervicotomy. Descriptive statistics were applied.Results: A total of 81 patients with non-toxic goiters had thyroid surgery. There were 76 (94%) females and five (6%) males. Average age was 46 years. Sixty-nine (85.2%) patients had no complication, while 12 (14.8%) patients had complications. Seventy-seven (95.1%) patients were discharged within 24 hours of surgery, while four (9.4%) patients were discharged within 48 hours. There was no mortality.Conclusions: The short-stay thyroidectomy model is feasible and safe in our environment, even in the presence of limited resources, and provides an alternative to the traditional 72 hour postoperative hospital stay.

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Section: Discussionmentioning

confidence: 99%

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

2020

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“…More recently, however, there has been some renewed interest in the use of regional anesthesia for various reasons and in selected patients. The benefits of regional anesthesia include the avoidance of the risks of airway instrumentation, of a difficult or failed intubation, and of general anesthesia [6,8,9,10]; earlier warning by an awake patient in case of risk of trauma or damage to the recurrent laryngeal nerve [8,9,10,11]; a shorter recovery period; significantly reduced costs [8,9,10]; better postoperative analgesia; and greater safety in patients with significant comorbidities and those who are poorly optimized preoperatively [8,11,12]. Regional anesthetic techniques that can be used for thyroidectomy include local infiltration, field block, superficial and/or deep cervical plexus block, and cervical epidural analgesia [6].…”

Section: Discussionmentioning

confidence: 99%

“…In spite of the availability of several authoritative guidelines and protocols on airway management [3,4], the management of each patient is unique and is often dependent on the skills and experience of the provider as well as the availability of appropriate equipment and armamentarium. The presence of a goiter is often associated with the risk of a difficult airway [5,6,7,8,9]. We report a case of a patient who had a large multinodular goiter with severe lateral compression of the trachea and retrosternal extension and had thyroidectomy done with cervical epidural anesthesia (CEA).…”

Section: Introductionmentioning

confidence: 99%

Cervical Epidural Anesthesia for Thyroidectomy in a Patient with a Potential Difficult and Compromised Airway

Verma¹,

Amata²,

Amir³

2018

jaccr

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We report a case of a 45-year-old man with a large thyroid swelling with the potential to cause a difficult and compromised airway. Cervical epidural anesthesia was planned and successfully performed to avoid difficult airway management. We conclude that cervical epidural anesthesia can be used for thyroidectomy in a patient with potential difficult and compromised airway. Keywords: Cervical epidural, thyroidectomy.

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“…La durée du séjour hospitalier, atteignant dix jours si l'intervention chirurgicale a été faite sous AG [ 1 ], a été nettement plus courte, n'ayant été que de deux jours, autant dans notre série que dans celle de Banasiewicz, opérant aussi sous AL [ 7 ]. Musa, ayant mené une étude dans des centres ruraux et semi-urbains du Nigéria, a retrouvé un coût de l'AR moins élevé que celui de l'AG [ 2 ]. Shukla, en Inde, a quantifié le coût de l'AG deux fois plus élevé que celui de l'AL [ 9 ].…”

Section: Discussionunclassified

“…Les thyroïdectomies constituent une intervention effectuée couramment par l'oto-rhino-laryngologiste (ORL) et le chirurgien cervico-facial, et sont généralement menées sous anesthésie générale (AG) [ 1 ]. La chirurgie thyroïdienne peut être également faite sous anesthésie régionale (AR) [ 2 – 4 ] ou sous anesthésie locale (AL) [ 5 – 9 ]. Notre objectif a été de rapporter notre expérience sur l'AL dans les thyroïdectomies, en la comparant avec l'AR et à l'AG, et avec les données de la littérature.…”

Section: Introductionunclassified

Thyroïdectomies pratiquées sous anesthésie locale au Centre Hospitalier Universitaire d’Antananarivo

Razafindrakoto¹,

Razafindranaivo²,

Valisoa³

et al. 2015

Pan Afr Med J

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Menée le plus souvent sous anesthésie générale, la chirurgie thyroïdienne peut aussi être pratiquée sous anesthésie régionale ou sous anesthésie locale. Notre objectif a été de rapporter l'expérience du Centre Hospitalier Universitaire d'Antananarivo sur l'anesthésie locale dans les thyroïdectomies. La drogue employée dans notre protocole anesthésique a été le fentanyl, administré en intraveineuse directe, associé à une infiltration sous-cutanée de lidocaïne suivant la ligne d'incision. Le/la patient(e) n'a pas été intubé(e), l'oxygène étant délivré au niveau des cavités nasales. Ont été étudiés le type de chirurgie thyroïdienne, la durée de l'intervention, la satisfaction des patient(e)s vis-à-vis de la qualité de l'anesthésie, et le coût de l'intervention. Sur 567 thyroïdectomies effectuées, 51,68% (n= 293) ont été des lobo-isthmectomies gauches, 44,44% (n= 252) des lobo-isthmectomies droites, 2,82% (n= 16) des thyroïdectomies subtotales ou totales, 1,06% (n= six) des totalisations pour carcinomes thyroïdiens. La durée des interventions a varié de 30 à 90 minutes. Un total de 83,95% (n= 476) des patient(e)s a été très satisfait de la qualité de l'anesthésie et 15,87% autres (n= 90) satisfait. Les suites opératoires ont été bonnes dans la majorité des cas. Le coût d'une thyroïdectomie a été évalué à 100- 150 dollars américains. L'anesthésie locale utilisée dans les thyroïdectomies effectuées au Centre Hospitalier Universitaire d'Antananarivo est simple, rapide, d'un coût moyen, et permet d'alarmer précocement le chirurgien en cas de lésion d'un nerf laryngé inférieur.

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General and regional anaesthesia for the thyroidectomy in rural/semi-urban Nigerian centres

Cited by 5 publications

References 26 publications

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

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

Cervical Epidural Anesthesia for Thyroidectomy in a Patient with a Potential Difficult and Compromised Airway

Thyroïdectomies pratiquées sous anesthésie locale au Centre Hospitalier Universitaire d’Antananarivo

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