Local/regional anesthesia for thyroidectomy: evaluation as an outpatient procedure

Area of Science:

• Anesthesiology
• Surgical Oncology
• Outpatient Surgery

Background:

• Local/regional anesthesia is increasingly utilized in outpatient surgical settings.
• Thyroid surgery traditionally involves general anesthesia.
• Evaluating the safety and efficacy of local/regional anesthesia for thyroidectomy is crucial.

Purpose of the Study:

• To review the evolving experience with local/regional anesthesia for thyroid operations in an outpatient setting.
• To assess patient outcomes, including discharge times and satisfaction.
• To determine the feasibility of same-day discharge after thyroidectomy under local/regional anesthesia.

Main Methods:

• A retrospective review of 203 consecutive patients undergoing thyroidectomy under local/regional anesthesia over 9 years.
• Patients were observed for 6 hours post-operation for potential complications before discharge.
• Discharge criteria included absence of neck swelling and no surgical contraindications.

Main Results:

• Most patients (77% in group C) were discharged within 6 hours, with no significant difference in discharge time based on anesthesia type.
• No hospital readmissions occurred; two patients required reoperation for postoperative bleeding.
• Patient-reported pain levels were comparable to dental procedures, with 95% rating it as equivalent or less severe.

Conclusions:

• Thyroidectomy can be safely performed using local/regional anesthesia in an outpatient setting.
• High patient satisfaction and low morbidity are achievable with this approach.
• Early discharge (6-8 hours) is feasible and not associated with increased readmission rates.