Service ORL Et Chirugie Cervico-Faciale, Centre Hospitalo-Universitaire de Tours, 2 Boulevard Tonnellé, 37044, Tours, France.
Service d'anesthésie-réanimation, Centre Hospitalo-Universitaire de Tours, 2 Boulevard Tonnellé, 37000, Tours, France.
Eur Arch Otorhinolaryngol. 2020 Mar;277(3):887-892. doi: 10.1007/s00405-019-05754-5. Epub 2019 Dec 5.
Minimally invasive parathyroid surgery and hypnosis are both increasing in prevalence. The objective of this study was to evaluate the efficacy of hypnoanalgesia compared with sedation during primary hyperparathyroid surgery under local anaesthesia.
All patients who underwent primary hyperparathyroid surgery under local anaesthesia in our department between January 2013 and April 2018 were included retrospectively in two groups: patients operated under hypnoanalgesia (HYP group), and patients operated under sedation (LA group). The evaluation criteria were postoperative pain and analgesic consumption, amount of perioperative anti-emetics required, and length of hospital stay.
Thirty-six patients were included, 19 in the HYP group and 17 in the LA group. Postoperative pain levels and analgesic consumption rates were lower in the HYP group (numeric scale = 0.5/10 vs. 2.7/10, p = 0.0001; 11% vs. 47%, p = 4.9 × 10). Intraoperative anti-emetics delivery was lower in the HYP group (5% vs. 35%, p = 2.9 × 10). The ambulatory care rate was higher in the HYP group (74% vs. 59%, p = 0.03).
Local anaesthesia with hypnoanalgesia, compared with sedation during minimally invasive parathyroid surgery, improved early postoperative outcomes, making outpatient management more efficient.
微创甲状旁腺手术和催眠术的应用都在增加。本研究的目的是评估局部麻醉下原发性甲状旁腺功能亢进症手术中催眠镇痛与镇静的疗效。
回顾性分析 2013 年 1 月至 2018 年 4 月期间在我科接受局部麻醉下原发性甲状旁腺功能亢进症手术的所有患者，分为两组：接受催眠镇痛（HYP 组）和接受镇静（LA 组）的患者。评估标准为术后疼痛和镇痛药用量、围手术期止吐药用量和住院时间。
共纳入 36 例患者，HYP 组 19 例，LA 组 17 例。HYP 组术后疼痛程度和镇痛药使用率较低（数字评分法=0.5/10 比 2.7/10，p=0.0001；11%比 47%，p=4.9×10）。HYP 组术中止吐药使用率较低（5%比 35%，p=2.9×10）。HYP 组门诊管理率较高（74%比 59%，p=0.03）。
与微创甲状旁腺手术中的镇静相比，局部麻醉下的催眠镇痛可改善术后早期结果，使门诊管理更有效。
