RESUMO
OBJECTIVE: To assess the capacity of different techniques to reduce non-operative times during parathyroid surgery. The impact of monitored anesthesia care (MAC) instead of general anesthesia, and the pre-operative placement of a second peripheral intravenous catheter (PIV) were analyzed. METHODS: A retrospective case series at an academic medical center was performed to study patients undergoing parathyroidectomy by a single surgeon between November 2013 and October 2016. Three operating room (OR) time measurements were compared: pre-incision time, post-closure time, and total OR time. RESULTS: Surgeries performed under MAC (nâ¯=â¯21) had statistically shorter pre-incision (33.2â¯min vs. 39.7â¯min, pâ¯<â¯.001), post-closure (10.1â¯min vs. 16.2â¯min, pâ¯=â¯.002), and total operative times (113.0â¯min vs. 151.5â¯min, pâ¯<â¯.001) compared to those in which general anesthesia (nâ¯=â¯169) was used. Of the 169 patients who underwent general anesthesia, 25 had a second PIV placed preoperatively and 144 had only a single PIV. All 3 time periods were statistically shorter in patients who had a second PIV versus those who had only a single PIV (pre-incision 32.2â¯min vs. 41.0â¯min, pâ¯<â¯.001; post-closure 12.2â¯min vs. 16.9â¯min, pâ¯<â¯.001; total 117.9â¯min vs. 157.4â¯min, pâ¯<â¯.001). CONCLUSIONS: In patients undergoing parathyroid surgery in which ioPTH levels will be used, the placement of a second PIV in the pre-operative holding area and performance of surgery under MAC can significantly shorten non-operative and total OR time.