Characteristics of patients having thyroid surgery under regional anesthesia

Background: Recently local/regional anesthesia has been reintroduced as an alternative to general anesthesia for thyroidectomy. This study was underta ken to analyze characteristics and outcomes of patients who had thyroid sur gery performed under regional anesthesia compared with those who had thyroi dectomy under general anesthesia. Study design: One hundred seventy-five consecutive patients who underwent t hyroid surgery under regional or general anesthesia during a 3-year period were analyzed. Fifty-eight operations were performed under regional anesthe sia and 116 under general anesthesia. Patient characteristics analyzed incl uded ap, gender, obesity, anesthesia class, and tumor pathology. Postoperat ive complications, including nausea or vomiting, were compared. Additionall y, operative times and length of stay in each group were compared. Results: Patient characteristics including age, gender, tumor pathology, an d anesthesia class were similar in both groups. But only 2% of patients tre ated under regional anesthesia were obese compared with 23% under general a nesthesia. Although not significant, there was a trend toward decreased inc idence of nausea and vomiting in the regional group. Other complications fo r the regional and general anesthesia groups were equal at 3%. Two patients required conversion to general anesthesia. Complications in the general an esthesia group included one episode of transient symptomatic hypocalcemia, two patients with transient vocal cord paralysis, and one episode of hemato ma. Finally, there was a statistically significant increase in total operat ing room time and length of stay for the general anesthesia group. Conclusions: Regional anesthesia is a safe alternative to general anesthesi a for patients undergoing thyroid surgery. Patients who cannot communicate verbally with the surgical team or who are obese may not be ideal candidate s for regional anesthesia. The use of regional anesthesia results in a decr eased length of stay and similar operative and operating room times. (J Am Coll Surg 2001; 193:367-372. (C) 2001 by the American College of Surgeons).