Int J Thyroid Res | Volume 1, Issue 1 | Research Article | Open Access
Aliyu S1, Ningi AB2* and Rabi’u M3
1Department of Surgery, University of Maiduguri Teaching Hospital, Nigeria
2Department of Surgery, Abubakar Tafawa Balewa University, Nigeria
3Department of Anesthesia, Abubakar Tafawa Balewa University, Nigeria
Background: The provision of quality health care is one of the priorities of every government. The quality of such care is however, limited by the human and technical resources available. The varying types of thyroidectomy for goiters are often done under general anesthesia, unless, there is a contraindication such as, cardiopulmonary instability. Recently, there is increasing evidence that thyroidectomy could be done under local anesthesia with or without anxiolytics or opioid analgesia augmentation. This study reports on our experience of performing thyroidectomy under infiltrative local anesthesia.
Objectives: To evaluate the safety of performing thyroidectomy under infiltrative local anesthesia and compare the post operative outcome with that done under general anesthesia. Patients and Methods: This is a descriptive case series of 59 patients that underwent thyroidectomy under field block with 1% lignocaine with adrenaline 1:200,0000 dilutions. Dose was standardized
for all patients at 4 mg/kg under monitored anesthesia. The period under study covered from October 2017, October 2019. The patients’ characteristics analyzed were biodata, clinical diagnosis, patient’s weight, type of surgery, duration of surgery and complications.
Results: The study population was 59 patients, 88.1% were females, and 11.9% were males, with female male ratio of 8:1. The mean age was 42.03( ± 3.5), simple multinodular goiter was the most common subtype 47.5%, toxic multinodular goiter 39%, diffuse simple goiter and diffuse toxic goiter 5.1% each. Malignant goiter 3.4% and all are papillary carcinomas. 54.2% off all the goiters are WHO grade III. The mean duration of surgery is 40 min and the average duration of hospital stay is 24 h to 48 h. There were 4 complications. 1) Subcutaneous hematoma (1.7%), 2) post-operative hypocalcaemia (1.7%), 3) colloidal scar (3.4%), and 4) surgical site infections (3.4%).
Conclusion: Thyroidectomy under infiltrative local anesthesia is safe if done by a trained surgeon, in a poor resource health facility.
Limitation: Patient’s preference for general anesthesia and short-necked, obese patients.
Keywords: Thyroidectomy; Anesthesia; Poor resource centre
Aliyu S, Ningi AB, Rabi’u M. Thyroidectomy Under Local Anesthesia in a Poor Resource Health Facility in Northeastern Nigeria. Int J Thyroid Res. 2020;1(1):1004..