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

Background. The purpose of this paper was to review my evolving experience with local/regional anesthesia in an outpatient setting Methods. Two hundred three consecutive patients during a 9-year period who chose to undergo thyroid operation under regional/local anesthesia were rev iewed. Early discharge was offered to patients who were observed for 6 hour s without neck swelling and who had no surgical reasons for delaying discha rge. Results. rn group A there were 2 patients who were given inhalation anesthe sia during operation compared with none in groups B and C. The average leng th of stay in group A was 0.49 days, 0.55 days in group B, and 0.24 days in group C. Eighty-five percent of the patients whose operation began before 1300 hours were discharged within 6 hours versus only 50 % of those operate d on later in the day. Forty-seven percent of patients in group A, 65 % of group B, and 77% of patients in group C were discharged within 6 hours of o peration. On the basis of previous experience with general anesthesia disch arge time is not significantly influenced by the type of anesthesia chosen. There were no readmissions to the hospital, but 2 episodes of postoperativ e bleeding required reoperation. Survey showed that 95% of patients rated t he level of pain equivalent or less severe than dental procedures under loc al anesthesia, and all patients would choose local again. Conclusions. These data suggest that thyroidectomy can be performed with th e patient under local/regional anesthesia, with low morbidity and high pati ent satisfaction. Most patients cart be discharged within 6 to 8 hours, and these discharges were not associated with readmissions.