Superficial cervical block in thyroidectomy in local anaesthesia

Thyroidectomy is traditionally performed under general anaesthesia with endotracheal intubation. Local anesthesia techniques are now used in patients deemed too ill to undergo general anesthesia because of severe comorbidity and or to those who live in extremely resource poor locations. In the last few decades there has been renewed interest in thyroidectomy under local anesthesia. The aims of this study were to assess the feasibility, safety, effectiveness and patients acceptability of bilateral superficial cervical plexus block for thyroidectomy in our hospital. This is a Retrospective study of all consenting adult patients who presented with goiter, thyroid malignancy had underwent thyroidectomy in LA. The study included 52 Patients above the age of 15 years who presented with thyroid swelling and had elective thyroidectomy done. Out of 52, there were 44 female and 8 were male, female to male ratio of 7.5:1. The mean age of the patients was 42.5 years, with a range of 15 to 55years. Types of goiter included 35(67%) simple goiters, 13 MNG, and 4 malignant cases (2 follicular and 2 papillary). Total thyroidectomy was done in 5 patients and subtotal thyroidectomy done in 10 patients. 98% of the patients found the anaesthesia satisfactory. Varying degrees of pressure symptoms during mobilization of the gland, and postural aches were common intra-operative problems encountered 98% of the patients found the anaesthesia satisfactory and would not mind recommending or having the same anaesthetic technique for a similar procedure. Two (2%) of the patients expressed dissatisfaction with the anaesthesia, they became extremely apprehensive during the surgery. Mean duration of surgery was 2 hours. Bilateral superficial cervical plexus block is a useful anaesthetic option for thyroidectomy, in most cases been the lack of anaesthetic facilities/or personnel, and surgeon’s preference, and associated cardiac or pulmonary disease. Cervical plexus block has also been found useful for thyroidectomy because it is feasible, safe, effective and easy to perform.