Regional Anesthesia in Thyroid Surgery for a Giant Intrathoracic Goiter With Tracheal Compression

Area of Science:

• Anesthesiology
• Regional Anesthesia
• Surgical Procedures

Background:

• Regional anesthesia, including cervical plexus block (CPB), serves as a safer alternative to general anesthesia (GA) for high-risk patients.
• CPB is traditionally used in carotid surgery and has proven effective for thyroid surgery, neck dissections, and other neck procedures.
• Superficial cervical plexus block (SBCP) is a simpler variant with fewer complications, achievable via landmarks or ultrasound guidance.

Observation:

• A case report details the anesthetic management of a patient with a giant retrosternal goiter causing severe tracheal compression.
• General endotracheal anesthesia was not feasible due to the patient's compromised airway.
• The surgical procedure was successfully performed under bilateral superficial cervical plexus block (BSCPB) anesthesia.

Findings:

• Bilateral superficial cervical plexus block (BSCPB) provided adequate analgesia for a complex neck surgery.
• This regional anesthesia technique was a viable alternative when general anesthesia was contraindicated.
• SCPB offers a safe and effective method for managing pain in specific surgical scenarios.

Implications:

• Superficial cervical plexus block (SCPB) is a valuable anesthetic option for procedures involving significant airway compression.
• Regional anesthesia techniques like BSCPB can improve patient safety and outcomes in high-risk surgical cases.
• This approach highlights the potential of regional anesthesia to overcome challenges associated with general anesthesia in complex neck surgeries.