title: General or local anaesthesia in one-day thyroid surgery-does it matter?
abstract: OBJECTIVE
  We aimed to determine the safety and feasibility of general anaesthesia (GA) compared with local anaesthesia + Monitored Anaesthesia Care (LA+MAC) for One-Day Thyroid Surgery (ODTS); to assess patient and operator satisfaction with either of the anesthetic approaches.
  
  
  METHODS
  We reviewed prospectively 130 patients who underwent ODTS from 2008 to 2011. 64 patients were operated on under GA and 62 - under LA+MAC. All variables of patient demographic characteristics, duration and type of operation, postoperative complications, difficulty in airway management and postoperative opiate consumption were recorded and analyzed.
  
  
  RESULTS
  There is no difference in respect to length of stay, discharge time and major/minor complications rate between two groups, but in the LA+MAC group, pain appears earlier and is more severe (56min; VAS 6, 5) than in GA patients (223 min; VAS 1, 5; p<0.001). Patient satisfaction was similar but the operator preference was greater for GA.
  
  
  CONCLUSIONS
  In experienced hands LA with MAC for Thyroidectomy is a safe and wise choice, but GA is even more so!
authors.affiliation: Department of Anaesthesiology and Intensive Care, University Hospital "Queen Giovanna"-Sofia, Sofia, Bulgaria.
authors.forename: Maya
authors.initials: M
authors.lastname: Belitova
authors.affiliation: Department of One-Day Surgery, University Hospital "Queen Giovanna"-Sofia, Sofia, Bulgaria.
authors.forename: Rumen
authors.initials: R
authors.lastname: Pandev
authors.affiliation: Department of Anaesthesiology and Intensive Care, University Hospital "Queen Giovanna"-Sofia, Sofia, Bulgaria.
authors.forename: Dimitar
authors.initials: D
authors.lastname: Karadimov
keywords: MAC; One-day thyroid surgery; complications; general anaesthesia; local anaesthesia