Thyroidectomy During Medical Outreach
AbstractBackground: Goiters are commonly seen in the low socioeconomic group with limited access to the specialists and specialized centres where this condition can be safely managed. Medical outreaches bring an opportunity for reprieve, but the setting and available facilities are often far from optimum. This study seeks to describe a safe approach to thyroid surgery in the limited settings of a medical outreach.
Methodology: In this study, 17 consecutive thyroidectomies done during medical outreaches, in several localities in Nigeria, between June 2010 and October 2010, are reported.
Results: In this study, 16 out of 17 patients had thyroidectomy done with local anaesthesia . The airway was monitored intra-operatively by speaking with the patients and using a pulse oximeter. A life threatening complication of intra-operative laryngospasm was seen in one of these
patients and was successfully managed by passing a laryngeal mask airway and conversion to general anaesthesia. In one patient with a giant
goiter, general anaesthesia was used and the patient intubated.
Conclusion: Thyroidectomy may be safely carried out in the awake patient with local anaesthesia. However, patients must be meticulously selected and all preparations must be made for promptly securing an airway.