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Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Local Anesthetics: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...

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Updated: Jul 18, 2026

"Sun's Seven-Step Technique" for Endoscopic En-Bloc Resection of Thyroid Cancer via the Chest-Breast Approach
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"Sun's Seven-Step Technique" for Endoscopic En-Bloc Resection of Thyroid Cancer via the Chest-Breast Approach

Published on: November 28, 2025

Seminars: local and regional anesthesia for thyroid surgery.

Nimmi Arora1, Panchali Dhar, Thomas J Fahey

  • 1Department of Surgery, New York Presbyterian Hospital, Weill Medical College of Cornell, New York, New York 10021, USA.

Journal of Surgical Oncology
|November 30, 2006
PubMed
Summary

Thyroidectomy can be safely performed under local or regional anesthesia, a technique historically used by expert surgeons. This approach is well-tolerated by most patients undergoing thyroid surgery.

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Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy
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Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy

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Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy
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Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy

Published on: October 24, 2025

Area of Science:

  • Endocrine Surgery
  • Anesthesiology
  • Surgical Oncology

Background:

  • Thyroidectomy is commonly performed by surgeons with diverse experience levels.
  • General anesthesia is the standard, offering patient comfort and ample surgical time.
  • Historically, thyroid surgery utilized local anesthesia, requiring significant surgeon expertise.

Purpose of the Study:

  • To review indications and contraindications for thyroidectomy under local/regional anesthesia.
  • To discuss technical considerations for performing thyroidectomy under local/regional anesthesia.

Main Methods:

  • Review of existing literature on thyroidectomy under local/regional anesthesia.
  • Analysis of indications, contraindications, and technical aspects.

Main Results:

  • Renewed interest in local/regional anesthesia for thyroidectomy in high-volume centers.
  • Identification of patient and procedural factors influencing anesthetic choice.

Conclusions:

  • Local and regional anesthesia are safe and well-tolerated for most thyroid surgery patients.
  • This anesthetic approach is a viable option for select thyroidectomy cases.