Approach to thyroid carcinoma in pregnancy

Area of Science:

• Oncology
• Anesthesiology
• Obstetrics

Background:

• Thyroid carcinoma is a common cancer, and the second most frequent malignancy diagnosed during pregnancy.
• Managing thyroid cancer in pregnant patients presents significant diagnostic and therapeutic challenges.
• Surgical intervention for thyroid cancer during pregnancy is common despite a lack of consensus on optimal approaches.

Purpose of the Study:

• To evaluate the safety and efficacy of thyroidectomy under local anesthesia with conscious sedation in pregnant patients.
• To explore alternative sedation methods like hypnosis for thyroid cancer surgery during pregnancy.

Main Methods:

• A retrospective review of 18 pregnant patients who underwent thyroidectomy between 2000 and 2016.
• Surgical procedure utilized local anesthesia (cervical plexus block) combined with conscious sedation (benzodiazepines and opiates).

Main Results:

• The combined technique of cervical plexus block and conscious sedation proved to be a safe method for thyroidectomy in pregnant patients.
• The study highlights a 15-year experience with this anesthetic approach.

Conclusions:

• Thyroidectomy under local anesthesia with conscious sedation is a safe and effective option for treating thyroid cancer in pregnant women.
• Hypnosis is suggested as a potential alternative to pharmacological sedation, particularly for patients seeking to avoid intravenous drugs.