ABSTRACT
Objective: to find effectiveness of thyroid surgeries under local anaesthesia when the patients had contraindication to general anesthesia
Study design: descriptive case series
Place and Duration of study: department of Surgery, Jinnah Hospital / Allama Iqbal Medical College Lahore, from January 2004 to March 2015
Methodology: a total of 100 patients were included. For infiltration anesthesia, lignocaine and bupivacaine were used. Two ampoules of lignocaine and two ampoules of bupivacaine [40 ml each] were taken and 160 ml normal saline was added in it. Total amount of infiltrate was 200 ml into which 0.5 ml of adrenaline 1/1000 was added. Total adrenaline concentration came to be 1/400000 in 200 ml. Before draping the patient, local anaesthesia was infiltrated starting from the incision, to all the area below from suprasternal notch to above the thyroid cartilage and laterally to anterior border of sternocleidomastoid. Patients were given tablet alprazolam [Xanax] 0.5 mg six hours prior to surgery. Just before the operation intramuscular injection diclofenac [Dicloran] 75 mg and intravenous antibiotics were also administered
Results: the study population included 81 females and 19 males with the mean age of 35+/-5 year. The mean procedure time was 105 minutes. Procedures included subtotal bilateral thyroidectomy [n=31], lobectomy [n=46] and total thyroidectomy [n=23]. Postoperative complications included bleeding [n=2]. Patients showed full self-dependency within 4 to 6 hours and remained under medical surveillance for 48 hours
Conclution: use of local anesthesia in thyroid surgery makes it cost effective with less postoperative pain. Early smooth recovery was also observed. Thyroid surgeries under local anesthesia may be considered a safe alternative where general anesthesia is not available or contraindicated for medical reasons