scholarly journals Post-operative pain control protocol for transoral endoscopic thyroidectomy vestibular approach (TOETVA): reply

Gland Surgery ◽  
2017 ◽  
Vol 6 (4) ◽  
pp. 422-423
Author(s):  
Angkoon Anuwong
2020 ◽  
pp. 000313482095030
Author(s):  
Emad Kandil ◽  
Mounika Akkera ◽  
Hosam Shalaby ◽  
Ruhul Munshi ◽  
Abdallah Attia ◽  
...  

Background Remote-access thyroid and parathyroid surgery has gained popularity recently due to its benefit of avoiding visible neck scars. Most of these techniques were described and performed in Asia, on patients with different body habitus compared to American patients. We aim to analyze the learning curve in performing these operations in North America.  Methods This is a retrospective cohort study of a 10-year experience by a single surgeon at a North American institute. Patients who underwent thyroid or parathyroid procedures by a transaxillary, retroauricular, or transoral endoscopic thyroidectomy vestibular approach (TOETVA) were included. Cumulative sum (CUSUM) was used to analyze learning curves based on intraoperative blood loss and total operative times and learning phases were divided accordingly. Results Three hundred seventy-two remote-access thyroid and parathyroid procedures were performed during the study period. Total operative time for transaxillary procedures was initially reduced after the 69th procedure and then again after the 134th case. For retroauricular procedures, marked reduction in the operative time was observed after 21 procedures. Most patients (57.02%) were discharged home on the same day during the mastering phase. In the transaxillary procedures, only 1 case of brachial plexus injury occurred prior to the routine use of somatosensory evoked potential (SSEP) monitoring. Discussion Remote-access thyroid and parathyroid surgeries can be performed safely with minimal complications in a select group of patients. Analysis of the learning curve in performing these operations aids in structuring a safe and effective learning period for endocrine surgeons seeking to venture into this modality of treatment.


Head & Neck ◽  
2020 ◽  
Author(s):  
Ved A. Tanavde ◽  
Christopher R. Razavi ◽  
Lena W. Chen ◽  
Rohit Ranganath ◽  
Ralph P. Tufano ◽  
...  

Author(s):  
Guibin Zheng ◽  
Xiaojie Wang ◽  
Guochang Wu ◽  
Haiqing Sun ◽  
Chi Ma ◽  
...  

2015 ◽  
Vol 25 (6) ◽  
pp. 470-476 ◽  
Author(s):  
Jingge Yang ◽  
Cunchuan Wang ◽  
Jinyi Li ◽  
Wah Yang ◽  
Guo Cao ◽  
...  

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hani Ali Ezzat ◽  
Galal Adel ElKady ◽  
Melad Ragaey Zekry ◽  
Dalia Ahmed Ibrahim ◽  
Abeer Sameer Salem

Abstract Background Strabismus is one of the common health problems among the children. The incidence of the oculocardiac reflex decreases with age and tends to be more pronounced in young, healthy patients, which is clinically significant for pediatric as it is observed with greatest incidence in young healthy neonates and infants undergoing strabismus surgery. Objective to prevent and attenuate the oculocardiac reflex in children age group from (2yrs to 14 yrs) undergoing surgical correction for strabismus. Patients and Methods Three groups were allocated Group C received general anaesthesia combined with pre emptive atropine, Group L received general anaesthesia combined with Peribulbar block with Lidocaine 2 % and Group LB which received general anaesthesia combined with peribulbar block with Levobupivacaine 0.5%. Results In Our study we found that group L which received peribulbar lidocaine 2 % was the most successful group regarding blocking the occurrence of the OCR and with acceptable post operative pain control results. Conclusion In Our study the use of peribulbar block with lidocaine 2 % in combinations with General anaesthesia is very effective against the incidence of OCR in children undergoing strabismus surgery and superior to the Iv pre emptive Atropine with higher surgeon satisfaction while the use of peribulbar levobupivacaine 0.5% combined with general anaesthesia has a great role in post operative pain control with superior patient satisfaction, on the other hand the atropine is a very important emergency drug but our study found that it has a very minor role in both preventing the OCR and post operative pain control in addition to subjecting the patients to the tachycardia and other complications like dryness of the mouth and blushing so its not recommended by our study.


2021 ◽  
Vol 65 (6) ◽  
pp. 860-861
Author(s):  
Alfio Tincani ◽  
Carlos Lehn ◽  
Cláudio Cernea ◽  
Emilson Queiroz ◽  
Fernando Dias ◽  
...  

2019 ◽  
Vol 23 (4) ◽  
pp. e2019.00036 ◽  
Author(s):  
Gustavo Fernandez-Ranvier ◽  
Aryan Meknat ◽  
Daniela E. Guevara ◽  
William B. Inabnet

Sign in / Sign up

Export Citation Format

Share Document