Email this article The effectiveness of combined anesthesia compared to general anesthesia in thyroid and parathyroid surgery: a single-center prospective randomized study
- Authors: Alekseev A.A.1, Yavorovsky A.G.1, Ovechkin A.M.1, Useinov A.V.1, Maksimova A.A.1
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Affiliations:
- Sechenov First Moscow State Medical University (Sechenov University)
- Issue: Vol 18, No 3 (2024)
- Pages: 261-271
- Section: Original articles
- URL: https://bakhtiniada.ru/1993-6508/article/view/284412
- DOI: https://doi.org/10.17816/RA633219
- ID: 284412
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Abstract
BACKGROUND. Surgeries involving the anterior neck (thyroidectomy, carotidectomy, plastic surgery, etc.) are widespread in Russia. Developing effective anesthesiological strategies for these procedures is a key goal in modern anesthesiology. The introduction of combined regional anesthesia techniques into surgical practice may help to minimize postoperative complications including severe pain syndrome, postoperative nausea, and vomiting.
AIM. To compare the effectiveness of combined anesthesia (general + regional) with general anesthesia alone in thyroid and parathyroid gland surgeries.
MATERIALS AND METHODS. In a prospective randomized study, 60 patients undergoing thyroid and parathyroid gland surgery were divided into two groups. Group 1 received general anesthesia combined with internal fascia of the neck block, bilateral block of the superficial branches of the cervical plexus, and block of ligament of Berry under ultrasound guidance. Group 2 received only general anesthesia. Hemodynamic profiles, plasma cortisol levels, fentanyl consumption, postoperative pain intensity, need for additional analgesia, and recovery time were evaluated.
RESULTS. Compared to the group receiving only general anesthesia, patients receiving combined (general + regional) anesthesia showed a decrease in fentanyl consumption (p <0.0001), lower plasma cortisol levels 12 hours post-extubation (p =0.0439), a reduction in median pain intensity after tracheal extubation 3 and 12 hours after surgery (p =0.0190, p <0.0001), as well as a twofold reduction in time from the end of surgery to extubation (p =0.0001). Additionally, patients in the combined anesthesia group had higher scores on the Aldrete recovery scale, indicating a quicker readiness for transfer to the recovery ward (p =0.0114).
CONCLUSION. The study demonstrated the effectiveness and safety of combined anesthesia in thyroid and parathyroid surgery, which provides adequate anesthetic protection for patients.
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##article.viewOnOriginalSite##About the authors
Anton A. Alekseev
Sechenov First Moscow State Medical University (Sechenov University)
Author for correspondence.
Email: aalekseev.aa@gmail.com
ORCID iD: 0009-0005-8598-7928
SPIN-code: 2536-1337
anesthesiologist
Russian Federation, MoscowAndrey G. Yavorovsky
Sechenov First Moscow State Medical University (Sechenov University)
Email: yavorovskiy_a_g@staff.sechenov.ru
ORCID iD: 0000-0001-5103-0304
SPIN-code: 1343-9793
MD, Dr. Sci. (Medicine), Professor, anesthesiologist
Russian Federation, MoscowAleksey M. Ovechkin
Sechenov First Moscow State Medical University (Sechenov University)
Email: ovechkin_a_m@staff.sechenov.ru
ORCID iD: 0000-0002-3453-8699
SPIN-code: 1277-9220
MD, Dr. Sci. (Medicine), Professor, anesthesiologist
Russian Federation, MoscowAndrey V. Useinov
Sechenov First Moscow State Medical University (Sechenov University)
Email: med.useinov@gmail.com
ORCID iD: 0000-0002-3426-0682
student
Russian Federation, MoscowAnastasia A. Maksimova
Sechenov First Moscow State Medical University (Sechenov University)
Email: am9165577382@yandex.ru
ORCID iD: 0009-0009-5260-6833
student
Russian Federation, MoscowReferences
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