Thyroid Surgery under Local Anaesthesia: Study of 30 Cases

Abstract

Background: Thyroidectomy is usually done under general anaesthesia.Objective: The purpose of the present study was to present our experience and evaluate effectiveness of thyroid surgery under local anaesthesia.Methodology: This is a cross-sectional study carried out in upazila health complex, Boalkhali, Chittagong and 250 bed General Hospital, Chittagong since January 2013 to December 2015. 30 patient underwent thyroidectomy for benign and malignant diseases under local anaesthesia. All patients are adult from 20 to 60 years, examined thoroughly investigated accordingly, euthyroid or made euthyroid, normotensive or made normotensive. Each patient was given Tab. Bromazepam 3mg at night before the day of surgery and repeated in morning on the day of surgery. Half an hour before the surgery patient is given injection Pethidine 1mg/kg I.M, injection Ketorolac 30mg I.V, injection Ranitidine 50mg I.V, injection Ondansetron 8mg I.V, injection Ceftriaxone 1gm I.V.Result: Among 30 patients male 8, female 22. Male-Female ration 1:2.75. Mean age 33.8 years. Mean lesion size 5.95cm. Mean Operation time: 91min. Surgery included hemithyroidectomy 18, subtotal thyroidectomy 8, total thyroidectomy 6. Post operative complication included infection in 1 and haematoma in 1 case.Conclusion: In our study thyroidectomy under local anaesthesia found effective and safe in a setup of limited anaesthesia facilities and safe alternative where general anaesthesia is contraindicated.Journal of Current and Advance Medical Research 2016;3(2):56-59

Thyroidectomy under Local Anaesthesia: A Viable Option in a Resource Limited Community

“…The average duration of surgery in this study was 90 minutes (45 to 135 minutes). This is similar to what was reported by other authors [9] [12] [13] [15] [17]. In a study conducted in Potiskum, Nigeria, the authors reported a mean duration of surgery of 40 minutes [16], much lower than what was observed in this study.…”

“…In a study carried out among patients who had thyroidectomy done under LA due to contraindication to GA, Kamran and colleagues reported 81 females and 19 males [12]. Ahmad and colleagues reported a female preponderance (22 females, and 8 males) in a cross sectional study of thyroid surgery under LA [13]. Similar findings of female preponderance among patients that had thyroidectomy under LA were also reported by other authors [14] [15] [16].…”

“…Rifat L et al [10] also reported same experience of satisfaction following surgery with their patients. Ahmed et al reported hematoma and wound infection in one patient each [13].…”

Euthyroidectomy under local versus general anesthesia in health camp settings in Uganda: a protocol for randomized prospective equivalence single-blind controlled trial

“…Albert Theodor Billroth was the first surgeon to popularize thyroid surgery, which encompassed primarily drainage of the thyroid cysts, although with concerns of post-operative pain and high levels of recurrence [ 7 ]. Subsequently, thyroidectomy was for years conventionally performed under regional local anesthesia (LA) resulting in loss of sensation and pain in a localized part of the body [ 8 – 10 ] with some series reporting favorable outcomes on over 20,000 patients as of 1990 [ 9 , 11 ].…”

“…Following the advancement of general anesthesia (GA) techniques in which a state of unconsciousness is induced with complete absence of pain and reflexes, the number of thyroidectomies performed under GA increased and ultimately, GA became the preferred method under which thyroidectomy is carried out. In the current surgical practice, majority of surgeons prefer to perform thyroidectomy under GA which offers the advantage of pain-free surgery to the patient, thus reducing their anxiety and enabling a more relaxed operating room environment for the surgeon [ 8 , 9 ].…”