Thyroid Lobectomy Under Local Anesthesia Before Lung Transplantation Owing to Diffuse Panbronchiolitis: A Case Report

Area of Science:

• Surgical Oncology
• Anesthesiology
• Pulmonology

Background:

• Thyroid lobectomy for cancer is typically performed under general anesthesia.
• Local anesthesia for thyroid surgery is rare, especially in high-risk patients.
• Diffuse panbronchiolitis poses significant risks for general anesthesia due to respiratory compromise.

Observation:

• A patient with thyroid cancer and severe respiratory compromise from diffuse panbronchiolitis was a high-risk candidate for general anesthesia.
• Spontaneous breathing was prioritized, necessitating avoidance of sedatives.
• Specific patient positioning, anesthesia screen adjustments, and frequent local anesthetic administration were employed.

Findings:

• Thyroid lobectomy was successfully completed under local anesthesia without sedation.
• Atropine sulfate was used to minimize salivation and swallowing.
• Energy devices were utilized to reduce blood loss and operative time, ensuring patient comfort and safety.

Implications:

• This case demonstrates the feasibility of thyroid lobectomy under local anesthesia in high-risk patients.
• The described techniques offer a viable alternative for patients with contraindications to general anesthesia.
• Effective pain and bleeding control are crucial for successful outcomes in minimally invasive thyroid surgery.