Our Summary

This study looked at 28 patients who had thyroid surgery with local anesthesia, meaning they were awake during the operation. Out of the group, 27 patients (96%) were able to have the surgery without issues. One patient needed to switch to general anesthesia because of a problem with their airway, and another had a panic attack. Generally, patients reported a moderate level of pain, averaging 3.4 on a scale of 0 to 10. The amount of pain was mainly related to how experienced the surgeon was with this type of surgery. Most patients (71%) only needed local anesthesia and didn’t need any extra drugs. The study suggests that having thyroid surgery with local anesthesia can be safe and well-tolerated, with possible benefits over general anesthesia. The more a surgeon does this type of surgery, the more comfortable patients may be.

FAQs

  1. What percentage of patients in the study were able to undergo thyroid surgery with local anesthesia without any issues?
  2. How is the level of pain during thyroid surgery with local anesthesia related to the surgeon’s experience?
  3. What benefits does the study suggest about having thyroid surgery with local anesthesia over general anesthesia?

Doctor’s Tip

One helpful tip a doctor might tell a patient about thyroidectomy is to discuss the option of having the surgery with local anesthesia instead of general anesthesia. This can potentially reduce the amount of pain experienced during the surgery and may have certain benefits over general anesthesia. It is important to have a discussion with your surgeon about the best option for you based on your individual situation.

Suitable For

Patients who are typically recommended for thyroidectomy include:

  1. Patients with thyroid cancer
  2. Patients with benign thyroid nodules that are causing symptoms or are suspicious for cancer
  3. Patients with hyperthyroidism (overactive thyroid) that is not controlled with medication
  4. Patients with large goiters (enlarged thyroid gland) that are causing difficulty breathing or swallowing
  5. Patients with recurrent thyroid nodules after previous surgery or treatment
  6. Patients with thyroid nodules that are causing hyperthyroidism or hypothyroidism
  7. Patients with Graves’ disease (autoimmune disorder that causes hyperthyroidism)
  8. Patients with thyroid cysts that are causing symptoms or are suspicious for cancer

Overall, the decision to recommend thyroidectomy will depend on the specific condition of the patient and their individual circumstances. It is important for patients to discuss their options with their healthcare provider to determine the best course of treatment for their thyroid condition.

Timeline

Before thyroidectomy:

  • Patient will undergo pre-operative evaluations, including physical exams, blood tests, imaging studies, and consultations with the surgeon and anesthesiologist.
  • Patient will be instructed to fast before the surgery and may need to stop certain medications.
  • On the day of the surgery, patient will be prepared for the operation, which may involve shaving the neck area and starting an IV line for fluids and medication.
  • Local or general anesthesia will be administered before the surgery begins.

After thyroidectomy:

  • Patient will be monitored closely in the recovery room for any complications, such as bleeding or difficulty breathing.
  • Patient may experience some pain and discomfort at the incision site, which can be managed with pain medication.
  • Patient may need to stay in the hospital for observation and to receive post-operative care.
  • Patient will be instructed on how to care for the incision site and any drains that may have been placed.
  • Patient may experience temporary changes in voice or difficulty swallowing, which typically improve over time.
  • Patient will have follow-up appointments with the surgeon to monitor healing and adjust medication dosages, if necessary.

What to Ask Your Doctor

  1. What are the reasons for recommending a thyroidectomy?
  2. What are the potential risks and complications associated with thyroid surgery?
  3. What type of anesthesia will be used during the surgery?
  4. What is the recovery process like after a thyroidectomy?
  5. How experienced is the surgeon in performing thyroid surgery with local anesthesia?
  6. Are there any alternative treatment options to consider?
  7. How long will I need to stay in the hospital after the surgery?
  8. Will I need to take any medications or make lifestyle changes after the surgery?
  9. What follow-up care will be required after the surgery?
  10. What is the long-term outlook for thyroid health following a thyroidectomy?

Reference

Authors: Haugen TW, Andera LN, LaMadrid AB. Journal: Laryngoscope. 2020 Mar;130(3):685-690. doi: 10.1002/lary.28196. Epub 2019 Jul 30. PMID: 31361327