Abstract
We evaluated the benefits of bilateral deep cervical plexus block regional anesthesia in healthy and high risk patients undergoing thyroid and parathyroid surgery and assessed its effects on respiratory function. Twenty-one patients undergoing thyroid and parathyroid operations were studied. Bilateral superficial and deep plexus blocks were performed in all patients except one (who received only superficial plexus block because of a slightly prolonged prothrombin time) with 0.375–0.5% bupivacaine with 1:200,000 epinephrine. Intraoperatively, supplemental intravenous sedatives/narcotics were titrated to achieve patient comfort and cooperation. To allay anxiety, patients were allowed to listen to music via headphones ntraoperatively. Forced vital capacity was measured before block, 10 minutes after the block and in the recovery room in half the patients. Eighteen patients tolerated the procedure well with supplemental sedation. Two patients required supplemental inhalation anesthesia via mask and one required tracheal intubation because of coughing prior to surgery. Three high risk patients tolerated the procedure well requiring only intraarterial line monitoring. Postoperatively, 11 patients had minimal incisional pain, 13 patients had mild pain on swallowing and 2 patients complained of nausea. There were no significant differences in the baseline forced vital capacity vs. forced vital capacity measured after the block and in the recovery room. This study indicates that regional anesthesia is an appropriate alternative to general anesthesia in selected patients undergoing thyroid and parathyroid surgery and did not compromise respiratory function.
Similar content being viewed by others
References
Lo Gerfo P., Ditkoff B.N., Chabot J., Feind C. Thyroid surgery using monitored anesthesia care: an alternative to general anesthesia. Thyroid 4:437, 1994.
Saxe A.J., Brown E., Hamburgerer S.W. Thyroid and parathyroid surgery performed with patient under regional anesthesia. Surgery 103: 415, 1988.
Bergenfelz A., Algotsson L, Ahren B. Surgery for primary hyperparathyroidism performed under local anaesthesia. Br. J. Surg. 79: 931, 1992.
Mehra A., Widerhorn J., Lopresti J., Rahimtoola S.H. Amiodarone induced hyperthyroidism: Thyroidectomy under local anesthesia. Am. Heart J. 122: 1160, 1991.
Hochman M., Fee W. Thyroidectomy under local anesthesia. Arch. Otolaryngol. Head Neck Surg. 117: 405. 1991.
Yerzingatsian K.L. Thyroidectomy under local analgesia: the anatomical basis of cervical blocks. Ann. R. Coll. Surg. Engl. 71: 207, 1989.
Author information
Authors and Affiliations
Additional information
Presented at the Sixty-Eighth Annual Meeting of the American Thyroid Association, Inc. Chicago, Illinois, September 28–October 1, 1994.
Supported in part by Research Grant DK18919, NIH, Bethesda, MD.
Rights and permissions
About this article
Cite this article
Kulkarni, R.S., Braverman, L.E. & Patwardhan, N.A. Bilateral cervical plexus block for thyroidectomy and parathyroidectomy in healthy and high risk patients. J Endocrinol Invest 19, 714–718 (1996). https://doi.org/10.1007/BF03347873
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03347873