scholarly journals Our experience of 200 cases of thyroid surgery under local anaesthesia versus general anaesthesia

2017 ◽  
Vol 3 (3) ◽  
pp. 683
Author(s):  
Sambhaji G. Chintale ◽  
Vilas R. Kirdak ◽  
Sonali P. Jatale ◽  
Kaleem Shaikh
Keyword(s):  
Length Of Stay ◽  
General Anaesthesia ◽  
Thyroid Surgery ◽  
Local Anaesthesia ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Work Load ◽  
Lesion Size ◽  
Safe Alternative ◽  
General Anaesthesia Group

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Local Anaesthesia is now being accepted universally as a safe alternative to general anaesthesia for thyroid surgery. This study was carried out to compare the outcomes of patients undergoing thyroid surgery under local and general anaesthesia. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">200 patients who underwent thyroid surgery for benign and malignant diseases under local and general anaesthesia from March 2014 to march 2017 were analysed. Patient characteristics analysed were age, sex, pathology lesion size, operating time, length of stay, cost and post-operative complications.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Mean lesion sizes were 4.5 cms and 6.5 cms in local and general anaesthesia group respectively. Mean operating time was 50, 5 minutes and 75.5 minutes in local anaesthesia and general anaesthesia group respectively. Mean cost incurred was Rs. 2500 in local anaesthesia and Rs. 5500 in general anaesthesia group. Mean length of hospital stay was 40, 25 hours and 75.06 hours in local anaesthesia and general anaesthesia group respectively. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Local anaesthesia is a safe alternative to general anaesthesia for patients undergoing thyroid surgery. Use of local anaesthesiahas resulted in a decreased length of stay, cost and means operating time, hence useful in a setup with limited anaesthesia time and increased work load.</span></p>

scholarly journals Thyroid Surgery under Local Anaesthesia: Study of 30 Cases

2018 ◽  
Vol 3 (2) ◽  
pp. 56-59
Author(s):  
Ashfaq Ahmad ◽  
Mamoon Ibn Amin ◽  
HS Mubarak Hossain ◽  
Muhammad Mukit Osman Chawdhury
Keyword(s):  
Thyroid Surgery ◽  
Local Anaesthesia ◽  
Operation Time ◽  
Lesion Size ◽  
Cross Sectional Study ◽  
Subtotal Thyroidectomy ◽  
Sectional Study ◽  
Safe Alternative ◽  
Cross Sectional ◽  
Surgery Patient

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

scholarly journals Thyroidectomy under Local Anaesthesia; Experience from a Tertiary Hospital in Kumasi, Ghana

2020 ◽  
Vol 2 (2) ◽  
pp. 01-07
Author(s):  
Anna Konney ◽  
Mawutor Dzogbefia ◽  
Philip Oppong Peprah ◽  
Derrick Gyimah ◽  
Isaac Barnor
Keyword(s):  
General Anaesthesia ◽  
Local Anaesthesia ◽  
Operating Time ◽  
Cost Effective ◽  
Tertiary Hospital ◽  
Tertiary Referral Hospital ◽  
Thyroid Lobectomy ◽  
Cervical Plexus Block ◽  
Plexus Block ◽  
The Cost

Objectives: Improvement in anaesthesia has allowed thyroidectomies to be performed mainly under general anaesthesia. There is however a growing interest in performing thyroid surgery under local or regional anaesthesia. The objective of this study was to analyse and share our experience with safety of thyroidectomy under regional cervical plexus block/ local anaesthesia in a tertiary referral hospital in Ghana. Materials and Methods: A retrospective study was conducted on all patients who had thyroidectomy under local anaesthesia from 1st January 2017 to 31st May 2018 in KATH. Data collected were demography, grade of goitre, operating time, and duration of hospital stay, complications and cost effectiveness of the procedure. Data was analysed using Stata version 16.0software. Results: A total of 105 thyroidectomies were done in the study period out of which 16 were done under local anaesthesia. All 16 patients (16 females, 100%) and majority 11 (68.75%) were aged between 30 and 50 years. 11 (68.75) had grade IB goitres. The most frequently performed surgery was thyroid lobectomy 12 (75%) and in 75% of cases the surgery was completed between 60 and 90 minutes. Most patients, 9 (56.25%) were discharged home within 48 hours following surgery. The cost of treatment was averagely 30% less compared to same surgery under general anaesthesia. No complications were recorded in the post-operative period. Conclusions: Comprehensive clinical assessment and careful patient selection for thyroidectomy under local anaesthesia result in good surgical outcomes. The procedure is safe and cost-effective and should be performed by experienced surgeons for the best outcomes.

Cost analysis of injection laryngoplasty performed under local anaesthesia versus general anaesthesia: an Australian perspective

2017 ◽  
Vol 132 (2) ◽  
pp. 168-172 ◽  
Author(s):  
D Chandran ◽  
C M Woods ◽  
M Schar ◽  
N Ma ◽  
E H Ooi ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Cost Analysis ◽  
General Anaesthesia ◽  
Local Anaesthesia ◽  
Cost Savings ◽  
Operating Theatre ◽  
Injection Laryngoplasty ◽  
Procedure Time ◽  
The Mean ◽  
American Society

AbstractObjective:To conduct a cost analysis of injection laryngoplasty performed in the operating theatre under local anaesthesia and general anaesthesia.Methods:The retrospective study included patients who had undergone injection laryngoplasty as day cases between July 2013 and March 2016. Cost data were obtained, along with patient demographics, anaesthetic details, type of injectant, American Society of Anesthesiologists score, length of stay, total operating theatre time and surgeon procedure time.Results:A total of 20 cases (general anaesthesia = 6, local anaesthesia = 14) were included in the cost analysis. The mean total cost under general anaesthesia (AU$2865.96 ± 756.29) was significantly higher than that under local anaesthesia (AU$1731.61 ± 290.29) (p < 0.001). The mean operating theatre time, surgeon procedure time and length of stay were all significantly lower under local anaesthesia compared to general anaesthesia. Time variables such as operating theatre time and length of stay were the most significant predictors of the total costs.Conclusion:Procedures performed under local anaesthesia in the operating theatre are associated with shorter operating theatre time and length of stay in the hospital, and provide significant cost savings. Further savings could be achieved if local anaesthesia procedures were performed in the office setting.

scholarly journals Pain and Vomiting after Vitreoretinal Surgery: A Potential Role for Local Anaesthesia

1995 ◽  
Vol 23 (4) ◽  
pp. 444-448 ◽  
Author(s):  
N. Williams ◽  
A. Strunin ◽  
W. Heriot
Keyword(s):  
General Anaesthesia ◽  
Local Anaesthesia ◽  
Potential Role ◽  
Neuromuscular Block ◽  
Operating Time ◽  
Vitreoretinal Surgery ◽  
Patient Comfort ◽  
Anaesthetic Technique ◽  
Control Group ◽  
Postoperative Vomiting

Periconal local anaesthesia with subtenon supplementation was used to provide anaesthesia for 94 patients having vitreoretinal surgery. Of these, 44 patients also received general anaesthesia with neuromuscular block. None of these patients received opioid or antiemetic before or during surgery. In comparison with a retrospective control group, patients who had received local anaesthesia as part of their anaesthetic technique were less likely to be given a parenteral opioid (P< 0.001) or to vomit (P<0.001) within six hours of the completion of surgery. They also experienced significantly fewer bradycardic episodes during surgery (P=0 001). For patients having general anaesthesia, administration of an intraoperative antiemetic reduced the incidence of vomiting within six hours of the completion of surgery (P=0.008). For patients who did not receive local anaesthetic, shorter operating time was a factor associated with both reduced postoperative vomiting (P=0.0015) and administration of parenteral opioid (P=0.0014). It is suggested that the use of local anaesthesia as part of the anaesthetic technique for vitreoretinal surgery is associated with improved patient comfort.

Standard Bipolar Diathermy Vessel Ligation for Thyroidectomy

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P45-P46
Author(s):  
James Russell Tysome ◽  
Rudaina Hassan ◽  
Jeremy Davis
Keyword(s):  
Thyroid Surgery ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Patient Discharge ◽  
Complication Rates ◽  
Bipolar Diathermy ◽  
Retrospective Case ◽  
Vessel Sealing ◽  
Chi Squared ◽  
Vessel Ligation

Objective Assess the safety and possible advantages of using bipolar diathermy with standard forceps, compared to clamp-and-tie for vessel ligation in thyroidectomy. Methods Retrospective case-control study of 153 patients undergoing thyroid surgery at our unit using the clamp-and-tie technique (January 2000-December 2002), compared to bipolar diathermy with standard bipolar forceps (January 2003-January 2006) for vessel ligation. Patient demographics, operating time, length of hospital stay, need for drain insertion, and complications (recurrent laryngeal nerve palsies, reactionary haemorrhage requiring re-exploration or late (>24h post-op) haematomas, hypocalcaemia) were compared between the two groups. Outcomes were compared using Prism (GraphPad Software, CA, USA). Data sets were initially tested for normal distribution using the D'Agostino and Pearson test of normality before comparison using two-tailed, unpaired t-tests, Mann-Whitney U test, Chi-squared or Fisher exact tests as appropriate, with p<0.05 considered significant. Results Significantly fewer drains were inserted and patients were discharged significantly earlier when standard bipolar diathermy was used for vessel ligation in hemithyroidectomies (p<0.001). The complication rates were similar for thyroidectomy using either technique, comparable to rates in large published series. Conclusions The use of bipolar diathermy with standard forceps for vessel ligation in thyroid surgery has been shown to be as safe and effective as the clamp-and-tie technique, while providing the advantage of the use of fewer drains, resulting in earlier patient discharge. This is a cost-efficient technique as it gives the advantage of reduced inpatient stay seen by others using bipolar vessel sealing devices or the harmonic scalpel, but without the expense.

scholarly journals Percutaneous Radiofrequency Facet Rhizotomy – Experience with 118 Procedures and Reappraisal of its Value

2000 ◽  
Vol 27 (2) ◽  
pp. 125-130 ◽  
Author(s):  
Wen-Ching Tzaan ◽  
Ronald R. Tasker
Keyword(s):  
General Anaesthesia ◽  
Local Anaesthesia ◽  
Operating Time ◽  
Spinal Pain ◽  
Outcome Data ◽  
Sensory Loss ◽  
Success Rates ◽  
Preoperative Pain ◽  
Significant Difference ◽  
Facet Denervation

ABSTRACT:Background:There have been many reports of percutaneous radiofrequency facet rhizotomy, perhaps better referred to as facet denervation, usually performed under general anaesthesia, with inconsistent success rates.Objectives:To report the authors' outcome data using both general and local anaesthesia and to reassess the value of this controversial procedure.Methods:Our experience with 118 consecutive percutaneous radiofrequency facet rhizotomies performed on 90 patients in the Toronto Western Hospital was analyzed. Sixty percent of the procedures were performed under general anaesthesia, 40% under local anaesthesia. All patients had been temporarily virtually relieved of pain after local anaesthetic blockade of the subject facets by an independent radiologist.Results:The patients were monitored from 1 - 33 (mean 5.6) months after surgery, with complete elimination or a greater than 50% subjective reduction of pain considered the criteria for success. For the first or only procedure this was 41% overall, 37% in cases done under local anaesthesia, 46% in cases done under general anaesthesia (difference not statistically significant p=0.52). There was no statistically significant difference in success rates for procedures performed in the cervical, thoracic or lumbosacral facets, with unilateral versus bilateral denervations, when two to three as compared with more than three facets were denervated, nor for operations done in patients who had had previous spinal surgery compared with those who had not. Results were not better regardless of whether hyperextension of the spine aggravated the patient's preoperative pain or not, and when the procedures were repeated in the same patient outcomes tended to be consistent, arguing against repetition of failed facet denervations. The morbidity was low, the chief problem being sensory loss and transient neuropathic pain in the distribution of cutaneous branches of posterior rami in the cervical and thoracic areas; mortality was zero.Conclusions:Percutaneous radiofrequency facet denervation is simple and safe, still worth considering in patients with disabling spinal pain that fails to respond to conservative treatment. The use of general anaesthesia shortens the operating time and the patient's discomfort without impairing success rate.

scholarly journals Propensity-matched analysis of general versus spinal anaesthesia for patients undergoing ankle fracture surgery

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0045 ◽  
Author(s):  
David Sing ◽  
Molly Vora ◽  
Paul Tornetta
Keyword(s):  
Length Of Stay ◽  
Adverse Events ◽  
General Anaesthesia ◽  
Spinal Anaesthesia ◽  
Ankle Fracture ◽  
Operating Time ◽  
Knee Surgery ◽  
Complication Rates ◽  
Improvement Program ◽  
Hip And Knee Surgery

Category: Ankle Introduction/Purpose: The choice of anaesthesia is a modifiable risk factor in optimizing post-operative outcomes in hip and knee surgery, with decreased rates of transfusion, thromboembolic events, and infection with the use of spinal anaesthesia versus general anaesthesia. Regional anaesthesia has been evaluated with respect to its effect on early pain in patients undergoing ORIF of the ankle, but there is no data regarding complication rates. The purpose of this study was to compare operating time, length of stay, and rates of post-operative adverse events within 30-days in patients undergoing open reduction and internal fixation (ORIF) of the ankle using spinal vs. general anaesthesia. Methods: Adult patients who underwent ORIF of a closed ankle fracture from 2012 to 2016 were identified from the American College of Surgeons National Surgical Quality Improvement Program database. Patients who were operated on after admission from the ED are not included in the database. Operative time (skin to skin), length of stay, thirty-day adverse events, and unplanned readmissions were compared between patients who received general anaesthesia and those who received spinal anaesthesia. Propensity-adjustment with respect to known risk factors for complications and adjunctive regional block was used to match patients using a 1:4 ratio of spinal to general anaesthesia. Adverse events tracked included wound dehiscence, surgical site infection (superficial and deep), sepsis, venous thrombolic events, cardiac events, prolonged intubation, need for unplanned intubation, return to operating room, pneumonia, urinary tract infection, renal insufficiency, and re-admission within 30 days. Comparisons were performed using a propensity based multivariate analysis. Results: Of the 10,795 patients meeting inclusion criteria, 9,862 (91.4%) were treated with only general anaesthesia and 933 (8.6%) were treated with only spinal anaesthesia. Using propensity-scored matching, 822 patients in the spinal cohort were matched to 3,288 patients in the general cohort with similar baseline demographics (61.5% female, mean age 56.4). Procedure performed was similar in both cohorts (47% lateral malleolus ORIF, 34% bimalleolar ORIF, 10% trimalleolar ORIF, 8% medial malleolus ORIF, 1% posterior malleolus ORIF). Spinal anaesthesia was associated with increased length of stay (+0.5 days, 95% confidence interval (CI) 0.20-0.75, p<0.001) and increased mortality (0.6% vs 0.2%, OR: 4.02, 95% CI 1.15-14.1, p=0.03). Rates of overall complications (4.0% vs 4.2%) and readmissions (0.8% vs 0.7%) were similar and available in Table 1. Conclusion: General anaesthesia is predominantly used for fixation of ankle fractures. While spinal anaesthesia is associated with lower complication rates in hip and knee surgery, we found no advantage in patients undergoing ORIF of the ankle.

A comparative study of voice outcomes and complication rates in patients undergoing injection laryngoplasty performed under local versus general anaesthesia: an Adelaide voice specialist's experience

2017 ◽  
Vol 131 (S1) ◽  
pp. S41-S46 ◽  
Author(s):  
D Chandran ◽  
C Woods ◽  
S Ullah ◽  
E Ooi ◽  
T Athanasiadis
Keyword(s):  
General Anaesthesia ◽  
Local Anaesthesia ◽  
Voice Handicap Index ◽  
Complication Rates ◽  
Post Injection ◽  
Injection Laryngoplasty ◽  
Patient Demographics ◽  
Management Algorithm ◽  
Significant Difference ◽  
General Anaesthesia Group

AbstractObjective:To compare clinical outcomes and complication rates in patients undergoing injection laryngoplasty performed under local versus general anaesthesia.Methods:A retrospective review was conducted of patients who underwent injection laryngoplasty performed by a single laryngologist in a tertiary Australian laryngology centre, between February 2013 and December 2014. Patient demographics, anaesthetic modality and complications were recorded. Voice Handicap Index 10 and the Grade, Breathiness, Roughness, Asthenia, Strain scale were evaluated.Results:Thirty-four laryngoplasties were performed under general anaesthesia and 41 under local anaesthesia, with mean patient ages of 59.5 and 68.8 years, respectively. Voice Handicap Index 10 scores were significantly improved post-injection (p< 0.001), with no significant difference between general anaesthesia and local anaesthesia (p> 0.05). All aspects of the Grade, Breathiness, Roughness, Asthenia, Strain scale showed significant improvement post-injection, except asthenia. There were seven (9.3 per cent) minor complications (five in the general anaesthesia group, two in the local anaesthesia group), all managed conservatively.Conclusion:Injection laryngoplasties performed under general anaesthesia and local anaesthesia offer similar voice outcomes, with comparable complication rates. Hence, development of a management algorithm for injection laryngoplasties performed under local anaesthesia is recommended.

Local anaesthesia and conscious sedation for cochlear implantation: experience with 20 patients

2015 ◽  
Vol 130 (2) ◽  
pp. 151-156 ◽  
Author(s):  
B Pateron ◽  
D Bakhos ◽  
A LeLouarn ◽  
P Bordure ◽  
A Bozorg Grayeli ◽  
...  
Keyword(s):  
General Anaesthesia ◽  
Cochlear Implantation ◽  
Local Anaesthesia ◽  
Conscious Sedation ◽  
Symptomatic Treatment ◽  
Good Alternative ◽  
Profound Hearing Loss ◽  
Significant Difference ◽  
Surgical Duration ◽  
General Anaesthesia Group

AbstractObjective:Cochlear implantation is mostly performed under general anaesthesia. This study aimed to evaluate cochlear implantation performed under local anaesthesia and sedation.Method:Twenty patients had a cochlear implant fitted under combined local anaesthesia (local anaesthesia group) and 41 patients had one fitted under general anaesthesia (general anaesthesia group) for bilateral profound hearing loss, from 2011 to 2014. Surgical duration, period of post-operative hospitalisation and early post-operative symptoms were compared. In the local anaesthesia group, operative symptoms reported during the surgery and by questionnaire were analysed.Results:Mean surgical duration was significantly shorter in the local anaesthesia group: 87 versus 122 minutes (p< 0.001). No significant difference was observed between the local anaesthesia and general anaesthesia groups regarding mean post-operative hospitalisation and early post-operative symptoms. Under local anaesthesia, patients had no particular symptoms in 60 per cent of cases. The remaining patients in this group experienced vertigo (10 per cent), pain (20 per cent) and pain-related movement (10 per cent) during the intervention. These symptoms can be controlled with symptomatic treatment.Conclusion:Combined local anaesthesia for cochlear implantation is a good alternative to general anaesthesia for co-operating patients.

scholarly journals A prospective clinical trial on comparison of thyroidectomy done with or without drain

2019 ◽  
Vol 6 (4) ◽  
pp. 1172
Author(s):  
Rajan V. K.
Keyword(s):  
Clinical Trial ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Thyroid Surgery ◽  
Length Of Hospital Stay ◽  
Hospital Patient ◽  
Suction Drainage ◽  
Routine Procedure ◽  
Group D ◽  
Drainage Group

Background: The practice of using the drain in thyroidectomy is common to avoid complications like a hematoma. Many surgeons use drain following thyroid surgery with an intention to evacuate the collected serum and blood. Objective was to evaluate the necessity of routine drainage and advantages in thyroidectomy.Methods: Prospective, non-randomized clinical trial was conducted for a duration of 1 year in 60 patients attended hospital. Patient were divided into two groups (Group WD and Group D). Epi-info version 7.0 was used for analysis. P<0.05 is considered statistically significant.Results: As seen the surgery was common in females which was significant (p<0.05) with the average age of 44 years in patients treated without drain while 42 years with drain. The most common diagnostic indication was found to be thyroid nodule. length of stay in hospital was less in patients were surgery was done with drain (2 days) (p<0.05).Conclusions: Significant reduction in length of hospital stay in drainage group compared to non-drainage group. So suction drainage should be done as a routine procedure.

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