Local Regional Anaesthesia in Toxic Goitre Surgery

Abstract

Operations performed under general anaesthesia (GA) in patients with toxic goitre (TG) have potentially fatal risks, such as thyroid storm. The safety of local regional anaesthesia (LRA) should therefore be investigated in TG cases as a potentially safer alternative to GA. The purpose of this study is to compare the outcomes achieved in patients with toxic goitre (TG) or euthyroid toxic goitre (ETG) treated with total thyroidectomy (TT) under LRA or GA. A total of 56 patients who underwent TT (all procedures were performed by a single surgeon) due to TG or ETG under LRA or GA in any of 3 separate hospitals were analysed. The factors analysed were age, sex, preoperative thyroid-stimulating hormone (TSH) values, visual analogue scale (VAS) score, mean operation time (MOT), pathology, mean hospitalisation time (MHT), mean cost (MC), and postoperative complications. In the GA group (Gp A) and the LRA group (Gp B), the mean age (MA) was 36 and 37 years, respectively; the MOT was 54.21 ± 5.09 and 72.50 ± 3.90 min, respectively; the MHT was 25.21 ± 1.21 and 9.62 ± 1097 h, respectively; and the MC was 3600 ± 0.0 and 1800 ± 0.0 Turkey’s Lira (TRY), respectively. The difference between our study and similar studies is that our study represents the first report to describe a case series of TG in which TT was performed under LRA. In TG cases requiring urgent thyroidectomy with no absolute contraindications to LRA, TT can be safely performed under LRA, which costs less than GA.