General or local anaesthesia in one-day thyroid surgery-does it matter?

Area of Science:

• Anesthesiology
• Surgical Oncology
• Endocrinology

Background:

• One-Day Thyroid Surgery (ODTS) offers benefits but requires careful anesthetic planning.
• General anesthesia (GA) and local anesthesia with Monitored Anesthesia Care (LA+MAC) are potential anesthetic options for ODTS.

Purpose of the Study:

• To compare the safety and feasibility of GA versus LA+MAC for ODTS.
• To evaluate patient and operator satisfaction with both anesthetic techniques.

Main Methods:

• A prospective review of 130 patients undergoing ODTS between 2008 and 2011.
• Patients were divided into two groups: 64 under GA and 62 under LA+MAC.
• Data collected included demographics, operation details, complications, airway management, and postoperative opiate consumption.

Main Results:

• No significant differences were observed in length of stay, discharge time, or major/minor complication rates between GA and LA+MAC groups.
• Pain onset was earlier and VAS scores were higher in the LA+MAC group (56 min; VAS 6.5) compared to the GA group (223 min; VAS 1.5; p<0.001).
• Patient satisfaction was comparable, but operators showed a greater preference for GA.

Conclusions:

• Both GA and LA+MAC are safe and feasible anesthetic options for ODTS in experienced hands.
• General anesthesia may provide superior postoperative pain management and is preferred by operators.