General or Local Anaesthesia in One-Day Thyroid Surgery-Does It Matter?

Abstract

Objective: We aimed to determine the safety and feasibility of general anaesthesia (GA) compared with local anaesthesia + Monitored Anaesthesia Care (LA+MAC) for One-Day Thyroid Surgery (ODTS); to assess patient and operator satisfaction with either of the anesthetic approaches. Material and Methods: We reviewed prospectively 130 patients who underwent ODTS from 2008 to 2011. 64 patients were operated on under GA and 62 - under LA+MAC. All variables of patient demographic characteristics, duration and type of operation, postoperative complications, difficulty in airway management and postoperative opiate consumption were recorded and analyzed. Results: There is no difference in respect to length of stay, discharge time and major/minor complications rate between two groups, but in the LA+MAC group, pain appears earlier and is more severe (56min; VAS 6, 5) than in GA patients (223 min; VAS 1, 5; p<0.001). Patient satisfaction was similar but the operator preference was greater for GA. Conclusion: In experienced hands LA with MAC for Thyroidectomy is a safe and wise choice, but GA is even more so! Turkish Başlık: Günübirlik Tiroid Cerrahisinde Genel veya Lokal Anestezi – Fark Eder mi? Anahtar Kelimeler: Günübirlik tiroid cerrahisi, genel anestezi, lokal anestezi, MAB, komplikasyonlar Amaç: Günübirlik Tiroid Cerrahisinde (GTC) lokal anestezi + Monitörize Anestezi Bakımına (LA+MAB) kıyasla genel anestezinin (GA) güvenliliği ve uygulanabilirliğini belirlemeyi ve anestetik yaklaşımların herbirine karşı hasta ve operatör memnuniyetini değerlendirmeyi hedefledik. Materyal ve Metotlar: 2008'den 2011'e kadar GTC uygulanan 130 hastayı prospektif olarak inceledik. 64 hasta GA altında ve 62 hasta LA+MAB altında opere edildi. Hastaların demografik özellikleri ile ilgili tüm değişkenler, operasyon tipi ve süresi , postoperatif komplikasyonlar, havayolu yönetimindeki zorluk ve postoperatif opiat tüketimi kayıt ve analiz edildi. Bulgular: İki grup arasında hastanede yatış süresi, taburculuk süresi ve majör/minör komplikasyon oranı açısından fark yoktur ancak LA+MAB grubunda (56 dk; VAS 6, 5), GA grubuna göre (223 dk; VAS 1, 5) ağrı daha erken ortaya çıkmaktadır ve daha şiddetlidir (p<0.001). Hasta memnuniyeti benzerdi ancak operatör tercihi GA için daha fazlaydı. Sonuç: Deneyimli ellerde Tiroidektomi için MAB ile LA güvenli ve akıllıca bir seçenektir ancak GA ondan daha iyidir!

Keywords

• One-day thyroid surgery, general anaesthesia, local anaesthesia, MAC, complications

General or Local Anaesthesia in One-Day Thyroid Surgery-Does It Matter?

Öz

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