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Local Anesthesia Simplifies Outpatient Thyroidectomies

Outpatient thyroidectomies performed with local anesthesia on eligible patients can achieve clinical results and patient satisfaction comparable with those done under general anesthesia, according to results of a prospective, randomized clinical trial.

Researchers at Texas A&M University in Temple, Tex., monitored 58 patients at Scott & White Memorial Hospital in Temple who underwent thyroidectomies between January 2000 and July 2001 (Arch. Surg. 2006;141:167–73). The patients' ages ranged from 19 to 80 years; 53 of the patients (91%) were women.

The patients were randomized into two groups of 29, and thyroidectomies were performed under general anesthesia in one group and under local anesthesia with monitored anesthesia care in the other. The same surgeon treated all patients.

Researchers found statistically significant differences in the amount of time patients in the two groups spent in postsurgical care, which included time spent in postanesthesia care and the combined time spent in postanesthesia care and the hospital's day surgery unit.

On average, patients who received local anesthesia spent 4 minutes in the postanesthesia care unit, compared with 80 minutes for those treated under general anesthesia. The combined time spent in the postanesthesia care unit and the day surgery unit for those treated under local anesthesia was 165 minutes, compared with 229 minutes for those under general anesthesia.

As a result of the earlier discharge, researchers estimated the per-patient savings at $315 for those treated with local anesthesia.

The researchers found no statistically significant differences in the number of patients undergoing either procedure who were admitted to the hospital after surgery or in the 30 days after initial discharge, the number of complications, or the overall satisfaction with their surgery or anesthesia management.

The researchers also noted a statistically significant difference in physician practice before and after the study. They compared a group of 58 consecutive thyroidectomy patients treated before the study with a group of 58 consecutive patients treated afterward. The share of outpatient procedures performed with local anesthesia and monitored anesthesia care rose from 21% to 50%, and the share of outpatient procedures performed with general anesthesia dropped from 79% to 50%.

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Outpatient thyroidectomies performed with local anesthesia on eligible patients can achieve clinical results and patient satisfaction comparable with those done under general anesthesia, according to results of a prospective, randomized clinical trial.

Researchers at Texas A&M University in Temple, Tex., monitored 58 patients at Scott & White Memorial Hospital in Temple who underwent thyroidectomies between January 2000 and July 2001 (Arch. Surg. 2006;141:167–73). The patients' ages ranged from 19 to 80 years; 53 of the patients (91%) were women.

The patients were randomized into two groups of 29, and thyroidectomies were performed under general anesthesia in one group and under local anesthesia with monitored anesthesia care in the other. The same surgeon treated all patients.

Researchers found statistically significant differences in the amount of time patients in the two groups spent in postsurgical care, which included time spent in postanesthesia care and the combined time spent in postanesthesia care and the hospital's day surgery unit.

On average, patients who received local anesthesia spent 4 minutes in the postanesthesia care unit, compared with 80 minutes for those treated under general anesthesia. The combined time spent in the postanesthesia care unit and the day surgery unit for those treated under local anesthesia was 165 minutes, compared with 229 minutes for those under general anesthesia.

As a result of the earlier discharge, researchers estimated the per-patient savings at $315 for those treated with local anesthesia.

The researchers found no statistically significant differences in the number of patients undergoing either procedure who were admitted to the hospital after surgery or in the 30 days after initial discharge, the number of complications, or the overall satisfaction with their surgery or anesthesia management.

The researchers also noted a statistically significant difference in physician practice before and after the study. They compared a group of 58 consecutive thyroidectomy patients treated before the study with a group of 58 consecutive patients treated afterward. The share of outpatient procedures performed with local anesthesia and monitored anesthesia care rose from 21% to 50%, and the share of outpatient procedures performed with general anesthesia dropped from 79% to 50%.

Outpatient thyroidectomies performed with local anesthesia on eligible patients can achieve clinical results and patient satisfaction comparable with those done under general anesthesia, according to results of a prospective, randomized clinical trial.

Researchers at Texas A&M University in Temple, Tex., monitored 58 patients at Scott & White Memorial Hospital in Temple who underwent thyroidectomies between January 2000 and July 2001 (Arch. Surg. 2006;141:167–73). The patients' ages ranged from 19 to 80 years; 53 of the patients (91%) were women.

The patients were randomized into two groups of 29, and thyroidectomies were performed under general anesthesia in one group and under local anesthesia with monitored anesthesia care in the other. The same surgeon treated all patients.

Researchers found statistically significant differences in the amount of time patients in the two groups spent in postsurgical care, which included time spent in postanesthesia care and the combined time spent in postanesthesia care and the hospital's day surgery unit.

On average, patients who received local anesthesia spent 4 minutes in the postanesthesia care unit, compared with 80 minutes for those treated under general anesthesia. The combined time spent in the postanesthesia care unit and the day surgery unit for those treated under local anesthesia was 165 minutes, compared with 229 minutes for those under general anesthesia.

As a result of the earlier discharge, researchers estimated the per-patient savings at $315 for those treated with local anesthesia.

The researchers found no statistically significant differences in the number of patients undergoing either procedure who were admitted to the hospital after surgery or in the 30 days after initial discharge, the number of complications, or the overall satisfaction with their surgery or anesthesia management.

The researchers also noted a statistically significant difference in physician practice before and after the study. They compared a group of 58 consecutive thyroidectomy patients treated before the study with a group of 58 consecutive patients treated afterward. The share of outpatient procedures performed with local anesthesia and monitored anesthesia care rose from 21% to 50%, and the share of outpatient procedures performed with general anesthesia dropped from 79% to 50%.

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