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Parathyroid surgery using monitored anesthesia care as an alternative to general anesthesia
B A Ditkoff1, J Chabot, C Feind
1Department of Surgery, Columbia University College of Physicians & Surgeons, New York, New York, USA.
American Journal of Surgery
|December 1, 1996
Summary
Local anesthesia (LA) is a safe and effective alternative for parathyroid surgery, offering faster recovery and shorter hospital stays compared to general anesthesia (GA). Experienced surgeons can successfully perform these procedures using LA.
Area of Science:
- Endocrinology
- Surgical Oncology
- Anesthesiology
Background:
- Limited data exists on parathyroid surgery under local anesthesia (LA).
- Renewed interest in LA for thyroid surgery contrasts with a lack of information for parathyroid procedures.
Purpose of the Study:
- To evaluate the safety and effectiveness of parathyroid surgery performed under local anesthesia (LA).
Main Methods:
- Retrospective review of 49 patients undergoing parathyroid surgery with LA.
- Bilateral cervical block (C2-C3) administered using lidocaine and bupivacaine.
- Comparison with a control group undergoing general anesthesia (GA).
Main Results:
- All surgeries were curative, with 46 parathyroid adenomas and 3 hyperplasias.
- LA group: 47% discharged within 6 hours, average 1.4-day stay, 6-day return to work.
- GA group: 27% outpatients, 1.6-day average stay, 8-day return to work.
- LA group had one hemorrhage (reoperation) and one conversion to GA; no nerve injuries or permanent hypoparathyroidism in either group.
Conclusions:
- Experienced surgeons can safely and effectively perform parathyroid surgery using LA.
- LA offers a viable alternative to general anesthesia for parathyroid procedures.