The Impact of Anesthesia in Thyroid Biopsy in Patients with Thyroid Nodules: A Systematic Review and Meta-Analysis
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Andressa Frankowski Dagostin1, Ana Luiza Potiguara2, Jacques A Greenberg3
1San Raffaele University, Milan, Italy.
Objective:
To evaluate whether anesthesia reduces pain and improves sample adequacy during thyroid fine needle aspiration biopsy (TFNAB).
Design:
Systematic review and meta-analysis.
Methods:
We systematically searched PubMed, Embase, Cochrane Library, and ClinicalTrials.gov from inception to April 2026 for studies comparing TFNAB with local or topical anesthesia versus TFNAB without anesthesia in patients with thyroid nodules. Primary outcomes were pain scores and sample adequacy. Secondary outcomes included the time of procedure duration and patient self-reported satisfaction. Risk ratios (RRs) and standardized mean differences (SMDs) with 95% confidence intervals were calculated using a random-effects model. All statistical analyses were performed on Review Manager software.
Results:
We included eight studies, comprising 1,186 patients with thyroid nodules that underwent FNA with and without anesthesia. Our pooled analysis showed that there were no significant differences between groups in reduction in pain scores (SMD -0.29; 95% CI -0.74 to 0.16; P=0.21) and sample adequacy (RR 1.09; 95% CI 0.95-1.26; P=0.23).
Conclusion:
Our study of 1,186 patients with thyroid nodules showed that TFNAB with anesthesia was not significantly associated with reduced pain scores and improved sample adequacy.
