Grycz Ewa, Siemiątkowski Andrzej
Department of Anaesthesiology and Intensive Therapy, Medical University of Białystok.
Anaesthesiol Intensive Ther. 2012 Jan-Mar;44(1):4-7.
Thyroidectomy is among the most frequently performed procedures in endocrine surgery. The hormonal response to surgery and anaesthesia depends in part on the anaesthetic techniques used; therefore, we measured serum concentrations of TSH, fT4, and fT3 in patients scheduled for elective thyroidectomy under TIVA or VIMA.
Seventy-eight adult patients, of both sexes, with non-toxic or hyperthyroid nodular goitre, were divided into groups with regard to the goitre type and the technique of anaesthesia used during thyroid surgery. Serum concentrations of TSH, fT4, and fT3, were measured and the surgical stress was estimated using the E-PASS scale.
In the groups examined, the mean serum concentrations of TSH remained unchanged during the period of observation. The initially high fT4 and fT3 concentrations gradually decreased, reaching their lowest level on the fourth day after surgery.
[corrected] Both VIMA and TIVA can be regarded as safe techniques of anaesthesia for thyroidectomy.
甲状腺切除术是内分泌外科最常进行的手术之一。手术和麻醉引起的激素反应部分取决于所采用的麻醉技术；因此，我们测量了计划在全凭静脉麻醉（TIVA）或静脉注射吗啡麻醉（VIMA）下进行择期甲状腺切除术患者的促甲状腺激素（TSH）、游离甲状腺素（fT4）和游离三碘甲状腺原氨酸（fT3）的血清浓度。
78例成年男女患者，患有非毒性或甲状腺功能亢进性结节性甲状腺肿，根据甲状腺肿类型和甲状腺手术期间使用的麻醉技术进行分组。测量TSH、fT4和fT3的血清浓度，并使用E-PASS量表评估手术应激。
在所检查的组中，观察期间TSH的平均血清浓度保持不变。最初较高的fT4和fT3浓度逐渐下降，在术后第四天达到最低水平。
VIMA和TIVA均可被视为甲状腺切除术的安全麻醉技术。
