Comparison between general anesthesia and superficial cervical plexus block in partial thyroidectomies.
Thyroidectomy under the effect of superficial cervical plexus block (SCPB) has met resistance.


OBJECTIVE
to compare variables in patients submitted to hemithyroidectomy under the effect of general anesthesia (GA) and SCPB.


METHODS
GA was used in 21 patients, and SCPB was used in another 21 patients. Following sedation, marcaine 0.5% with vasoconstrictor was used in the SCPB group. Intraoperative sedation with diazepam and metoprolol to control arterial pressure and cardiac frequency was given as needed. GA followed the standard method in the unit.


RESULTS
We found significant results (p<0.05, Students t-test) for surgery time (GA - 111.4 min; SCPB - 125.5 min), anesthesia time (GA - 154.1 min; SCPB - 488.6 min), time in the surgery room (GA - 15 min; SCPB - 1 min), treatment costs (GA - R$203.2; SCPB - R$87.4), presence of bradycardia (GA - 0; SCPB - 23.8%) and laryngotracheal injury (GA - 51; SCPB - 0 %). We also found the following non-significant results: hospitalization time (GA - 17.3; SCPB - 15.1 hours); bleeding volume (GA - 41,9 g; SCPB - 47.6 g), size of the operative specimen (GA - 52.1 cm3; SCPB - 93.69 cm3) and patient satisfaction level (GA - 3.8; SCPB - 3.9).


CONCLUSIONS
Although the incidence of bradycardia was higher (23.8%), SCPB was done for the resection of tumors measuring up to 348 cm3, at a lower cost and with no laryngotracheal injuries; these were present in 51% of patients undergoing GA.
Mamede
Rui Celso Martins
RC
Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, FMRP, HC, USP, SP, Brazil. rcmmamed@fmrp.usp.br
Raful
Helder
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000768:Anesthesia, General / Q000009:adverse effects / Q000191:economics; D000772:Anesthesia, Local / Q000009:adverse effects / Q000191:economics; D000779:Anesthetics, Local / Q000009:adverse effects / Q000627:therapeutic use*; D001919:Bradycardia / Q000139:chemically induced; D002572:Cervical Plexus; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D017060:Patient Satisfaction; D013959:Thyroid Diseases / Q000601:surgery*; D013965:Thyroidectomy / Q000191:economics / Q000379:methods*; D013997:Time Factors
D000779:Anesthetics, Local