Geisinger Medical Center, Danville, Pennsylvania, U.S.A.
Manila Adventist Medical Center, Pasay City, Metro Manila, Philippines.
Laryngoscope. 2020 Mar;130(3):685-690. doi: 10.1002/lary.28196. Epub 2019 Jul 30.
In this article, we present a series of 28 patients who underwent thyroid surgery using local anesthesia. We describe our technique, report outcomes, and assess how well the procedure was tolerated from a patient perspective.
Three surgeons performed awake thyroidectomies and recorded data, including the patient's age and gender, surgery being performed, operative time, weight of the surgical specimen, quantity and type of local anesthetic used, additional medications, patient-reported pain assessment, and any complications.
Twenty-seven of 28 patients (96%) successfully underwent awake thyroidectomy. One patient had to be converted to general anesthesia due to airway concerns. There were no complications; however, one patient had a panic attack. Based on a 0 to 10 scaled pain score, the average amount of pain reported was 3.4. The amount of pain the patient reported was significantly dependent on the amount of experience the operating surgeon had with this technique. Seventy-one percent of patients tolerated surgery with local anesthesia only and did not require additional medications.
Awake thyroidectomy is a well-tolerated and safe procedure in appropriately selected patients, with many potential benefits over general anesthesia. In most cases, only local anesthesia is required. Increased experience with this technique may be associated with increased patient comfort.
4 Laryngoscope, 130:685-690, 2020.
本文介绍了 28 例在局部麻醉下接受甲状腺手术的患者。我们描述了我们的技术，报告了结果，并从患者的角度评估了该手术的耐受性。
三位外科医生进行了清醒甲状腺切除术并记录了数据，包括患者的年龄和性别、手术类型、手术时间、手术标本的重量、使用的局部麻醉剂的数量和类型、其他药物、患者报告的疼痛评估以及任何并发症。
28 例患者中有 27 例（96%）成功接受了清醒甲状腺切除术。一名患者因气道问题需要转为全身麻醉。无并发症，但有 1 例患者发生恐慌发作。根据 0 到 10 的疼痛评分量表，报告的平均疼痛程度为 3.4。患者报告的疼痛程度与手术医生使用该技术的经验量显著相关。71%的患者仅使用局部麻醉即可耐受手术，无需额外药物。
在适当选择的患者中，清醒甲状腺切除术是一种耐受性良好且安全的手术，与全身麻醉相比具有许多潜在优势。在大多数情况下，仅需要局部麻醉。随着对该技术经验的增加，患者的舒适度可能会增加。
4 级，喉镜，130：685-690，2020 年。
