Our Summary

This research paper investigates ways to reduce the time taken for non-operative procedures during parathyroid surgery. The study looks at the effects of using monitored anesthesia care (MAC) instead of general anesthesia and placing a second intravenous catheter (PIV) before the operation.

The study reviewed surgeries performed by a single surgeon at an academic medical center from November 2013 to October 2016. It compared three timing measurements: the time before the incision, the time after the surgery closure, and the total time in the operating room.

The results showed that surgeries performed under MAC took less time before the incision, after surgery closure, and overall compared to surgeries using general anesthesia. For surgeries under general anesthesia, the patients who had a second PIV placed beforehand also had shorter times in all three measurements compared to those with only one PIV.

Therefore, the study suggests that using MAC and placing a second PIV before surgery can significantly cut non-operative and total time in the operating room for patients undergoing parathyroid surgery.

FAQs

  1. What does the study suggest to reduce non-operative time during parathyroid surgery?
  2. How does the use of monitored anesthesia care (MAC) affect the timing of parathyroid surgeries compared to general anesthesia?
  3. What was the effect of placing a second intravenous catheter (PIV) before surgery on the time measurements of surgeries under general anesthesia?

Doctor’s Tip

One helpful tip a doctor might tell a patient about parathyroidectomy is to discuss with their healthcare provider the option of using monitored anesthesia care (MAC) instead of general anesthesia for the surgery. Additionally, it may be beneficial to have a second intravenous catheter (PIV) placed before the operation to help reduce the overall time spent in the operating room. These strategies could potentially lead to a smoother and more efficient surgical experience for the patient.

Suitable For

Patients who are typically recommended for parathyroidectomy include those with primary hyperparathyroidism, secondary hyperparathyroidism, and tertiary hyperparathyroidism. Primary hyperparathyroidism is the most common reason for parathyroidectomy and is often caused by a benign tumor on one of the parathyroid glands. Secondary hyperparathyroidism is commonly seen in patients with chronic kidney disease, while tertiary hyperparathyroidism occurs in patients who have had a kidney transplant.

Other patients who may be recommended for parathyroidectomy include those with symptoms such as kidney stones, bone fractures, osteoporosis, fatigue, and muscle weakness. Additionally, patients with high levels of calcium in the blood, known as hypercalcemia, may also be candidates for parathyroidectomy.

Overall, patients who have been diagnosed with a parathyroid disorder and are experiencing symptoms or complications related to high levels of parathyroid hormone or calcium in the blood are typically recommended for parathyroidectomy.

Timeline

Before Parathyroidectomy:

  1. Consultation with a healthcare provider to discuss symptoms, medical history, and treatment options.
  2. Pre-operative tests such as blood work, imaging studies, and possibly a biopsy to confirm the diagnosis of hyperparathyroidism.
  3. Pre-operative instructions given by the healthcare team, including fasting before surgery and any medications to avoid.
  4. Admission to the hospital or surgical center on the day of the surgery.

After Parathyroidectomy:

  1. Recovery in the post-anesthesia care unit (PACU) immediately following the surgery.
  2. Monitoring of vital signs and pain management in the PACU.
  3. Discharge home or to a hospital room once stable and able to walk.
  4. Follow-up appointments with the surgeon to monitor healing and discuss any further treatment or medication adjustments.
  5. Long-term follow-up to monitor calcium levels and overall health post-surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with parathyroidectomy?

  2. How long is the recovery period after parathyroidectomy surgery?

  3. Will I need to take any medications or follow a special diet after the surgery?

  4. What can I expect in terms of pain management during and after the surgery?

  5. How soon after the surgery can I resume normal activities, such as work or exercise?

  6. Are there any long-term effects or complications I should be aware of after the surgery?

  7. Will I need to have any follow-up appointments or tests after the surgery?

  8. What are the success rates of parathyroidectomy in treating my condition?

  9. Are there any alternative treatment options to consider before proceeding with surgery?

  10. How experienced are you in performing parathyroidectomy surgeries, and what is your success rate with this procedure?

Reference

Authors: Iwata AJ, Wertz AS, Alluri S, Singer MC. Journal: Am J Otolaryngol. 2019 Nov-Dec;40(6):102292. doi: 10.1016/j.amjoto.2019.102292. Epub 2019 Sep 10. PMID: 31537429