THE SAFETY PROFILE AND EFFICIENCY OF THYROIDECTOMY UNDER LOCAL ANAESTHESIA

Abstract

Introduction: Thyroidectomy is done in many indications ranging from thyroid cancers to nodular types of the thyroid. There are several types of thyroidectomy in which complete removal is done or segmental removal is also preferred. Removal of thyroid tissue is done both in benign and malignant diseases of the thyroid. Thyroid surgery was conducted utilising local anaesthetic procedures in the early twentieth century. As general anaesthesia became safer, doctors began to perform thyroidectomy under general anaesthetic exclusively. Recent accounts of thyroidectomy under local anaesthesia, on the other hand, state that the results are comparable to thyroidectomy under general anaesthetic.
 Hypothesis: It is hypothesised that thyroidectomy can be effectively performed by applying local anaesthesia with Monitored Anaesthesia Care. The similar or better outcome can be obtained as compared to general anaesthesia.
 Materials and Methods: The present study is a retrospective study that was conducted during the period of eight Months. Applying inclusion and exclusion criteria, 110 patients were considered for this study. These 110 patients were scheduled for thyroidectomy. The study classified the patients according to the type of anaesthesia they received. Group 1 patients are those who were given general anaesthesia while group 2 patients were given local anaesthesia with MAC. The main outcomes were assessed by several factors and specially shifting of choice of anaesthesia (local or general).
 Setting: The university affiliated hospital with more than 700 beds.
 Results: Significant findings were obtained in number of patients were admitted to PACU, number of patients with PONV, time spent in PACU, difficult urination, etc. These findings have shown that shifting trend to local anaesthesia with MAC after the study.Hence there is a shift of choice towards local anaesthesia with MAC. Half of the patients are later anaesthesized by local anaesthesia (P<0.005).
 Conclusion: The study concludes that the local anaesthesia with MAC is effective and safe to be used in thyroidectomy and can replace general anaesthesia.
 Keywords: thyroidectomy, thyroid gland, local anaesthesia, general anaesthesia