[Thyroidectomy in the ambulatory setting. A prospective study]

Area of Science:

• Anesthesiology
• Surgical Oncology
• Endocrine Surgery

Background:

• Local/regional anesthesia (LRA) enables outpatient thyroidectomy.
• Comparing LRA with sedation versus LRA with intubation is crucial for optimizing ambulatory surgery.
• Patient selection criteria are key for successful outpatient thyroidectomy.

Purpose of the Study:

• To compare the outcomes of thyroidectomy using two anesthesia methods: LRA with sedation versus LRA with intubation.
• To evaluate postoperative recovery, morbidity, and patient satisfaction in outpatient thyroidectomy.
• To determine the safety and efficacy of different anesthesia techniques for ambulatory thyroid surgery.

Main Methods:

• Prospective study of 125 patients meeting outpatient thyroidectomy criteria.
• Two anesthesia groups: LRA with sedation (n=58) and LRA with orotracheal intubation (CLRA, n=67).
• Evaluation of postoperative vomiting, pain, admission rates, morbidity, and home complaints.

Main Results:

• No significant differences in surgical outcomes or intraoperative events between LRA and CLRA groups.
• Faster discharge hour observed in the LRA group (6.5 hrs) compared to CLRA (7.76 hrs).
• Similar rates of postoperative morbidity, pain, and patient satisfaction (≥95%) in both groups.

Conclusions:

• Outpatient thyroidectomy is safe and well-tolerated in selected patients.
• LRA with sedation facilitates a faster postoperative recovery compared to LRA with intubation.
• Both anesthesia methods are viable for outpatient thyroidectomy, with LRA offering a recovery advantage.