TITLE

Thyroidectomy: Exactly How Painful Is It?

AUTHOR(S)
Kalmovich, Limor Muallem; Cote, Valerie; Sands, Noah; Black, Martin; Payne, Richard; Hier, Michael
PUB. DATE
June 2010
SOURCE
Journal of Otolaryngology -- Head & Neck Surgery;Jun2010, Vol. 39 Issue 3, p277
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: The level of pain post-conventional thyroidectomy has been studied from two aspects: the short-term effect of different perioperative analgesics on the pain level and in comparison with endoscopic thyroidectomy. Objective: The level of pain experienced post-open thyroidectomy and postoperative long-term analgesia requirements have not been prospectively studied. We have undertaken this study to have a clearer understanding of this issue. We also compared the implication of two different surgical approaches toward the sternothyroid muscle: retraction versus incision on the level of postoperative pain. Methods: Prospective screening of 53 patients undergoing total thyroidectomy was conducted. Patients received a form containing information as to analgesic drugs taken postoperatively and a self-estimated pain severity scale. Results: The pain level decreased steadily from the first postoperative evening, and the average pain level at the peak was moderate. Most of the patients chose not to use narcotics. In our study population, males, as a trend, reported higher pain levels compared with females and for a longer duration. Sternothyroid muscle division did not increase pain level, the duration of pain, or the pattern of postoperative analgesic requirements. Conclusions: We recommend that only patients with severe pain, on the first postoperative day, be prescribed mild narcotics in small quantities. All others can be prescribed with a nonnarcotic analgesia. We did not find evidence that sternothyroid muscle splitting causes more pain; hence it should be used at the surgeon's discretion.
ACCESSION #
50881648

 

Related Articles

  • Trans-areola single-site endoscopic thyroidectomy: pilot study of 35 cases. Youben, Fan; Bo, Wu; Chunlin, Zhong; Jie, Kang; Bomin, Guo; Fan, Yang; Xianzhao, Deng; Qi, Zheng // Surgical Endoscopy;Apr2012, Vol. 26 Issue 4, p939 

    Background: Endoscopic thyroidectomy via thoracic/breast approach is an acceptable and successful technique in Asia. This technique has the advantage of better cosmesis compared with open or even video-assisted thyroidectomy. Unfortunately, because of the need for three separate ports,...

  • Total Video Endoscopic Thyroidectomy by an Axillary Approach. Chantawibul, Suchart; Lokechareonlarp, Santi; Pokawatana, Chairat // Journal of Laparoendoscopic & Advanced Surgical Techniques;Oct2003, Vol. 13 Issue 5, p295 

    Background: A permanent transverse surgical scar is an unavoidable problem after conventional thyroidectomy. Endoscopic thyroidectomy performed via an axillary approach leaves no scarring at the neck and anterior chest wall and so provides an excellent cosmetic result. The axillary scars are...

  • Endoscopic thyroidectomy in China. Ng, W. T. // Surgical Endoscopy;Jul2009, Vol. 23 Issue 7, p1675 

    The article focuses on the growth of endoscopic thyroidectomy in China. It informs that in China the first endoscopic thyroidectomy by the breast approach was performed in 2001 and since then, an estimated 10,000 thyroidectomies have been performed under endoscopic vision. According to a survey,...

  • Video-assisted thyroidectomy for Graves' disease. Berti, P.; Materazzi, G.; Galleri, D.; Donatini, G.; Minuto, M.; Miccoli, P. // Surgical Endoscopy;Aug2004, Vol. 18 Issue 8, p1208 

    Background: Ever since the introduction of video-assisted thyroidectomy (VAT). Graves' disease has represented a contraindication. This study aimed to demonstrate that VAT can be proposed also for Graves' disease. Methods: From January 2002 to March 2003, 21 patients (20 women and 1 man)...

  • Endoscopic Thyroidectomy Using a Gasless Axillary Approach. Jung, Eun-Jung; Park, Soon-Tae; Ha, Woo-Song; Choi, Sang-Kyung; Hong, Soon-Chan; Lee, Young-Joon; Jeong, Chi-Young; Joo, Young-Tae; Moon, Hyeong-Gon // Journal of Laparoendoscopic & Advanced Surgical Techniques;Feb2007, Vol. 17 Issue 1, p21 

    Purpose: We have recently developed an endoscopic thyroidectomy using a gasless axillary approach and report the surgical outcome of the procedure. Materials and Methods: The gasless axillary approach was performed through a 3-cm axillary incision using a retractor instead of carbon dioxide...

  • Commentary on transoral access for endoscopic thyroid resection. Dionigi, Gianlorenzo; Rovera, Francesca; Boni, Luigi // Surgical Endoscopy;Feb2009, Vol. 23 Issue 2, p454 

    The author reflects on transoral access for endoscopic thyroid resection. The author claims that the impact of technologies like the transoral approach on quality of thyroid surgery is remarkable. The author discusses the transoral technique introduced by Witzel and colleagues. He observes that...

  • The endoscopic approach to the Neck: A review of the literature, and overview of the various techniques. Muenscher, Adrian; Dalchow, Carsten; Kutta, Hannes; Knecht, Rainald // Surgical Endoscopy;May2011, Vol. 25 Issue 5, p1358 

    Background: The endoscopic surgical approach to the neck has reached the head and neck surgeons' view with a certain delay, compared to other fields of endoscopic procedures. This may be attributed to the tight work space and plenty of vital structures in the operating field. Since study groups...

  • LigaSure versus Conventional Hemostasis in Thyroid Surgery: Prospective Randomized Controlled Trial. Singh, Prabhjyot; O'Connell, Daniel; Langille, Moran; Dziegielewski, Peter; Allegretto, Michael; Harris, Jeffrey // Journal of Otolaryngology -- Head & Neck Surgery;Aug2010, Vol. 39 Issue 4, p378 

    Background: Meticulous hemostasis is a critical and often time-consuming step of safe thyroid surgery. The LigaSure system (Valleylab, Boulder, CO) is a diathermy hemostasis method that fuses vessel walls to form a collagen seal. Previous studies have shown reduced operative times in...

  • Laryngeal Reinnervation Using Ansa Cervicalis for Thyroid Surgery-Related Unilateral Vocal Fold Paralysis: A Long-Term Outcome Analysis of 237 Cases. Wei Wang; Donghui Chen; Shicai Chen; Ding Li; Meng Li; Siwen Xia; Hongliang Zheng // PLoS ONE;2011, Vol. 6 Issue 4, p1 

    Objective: To evaluate the long-term efficacy of delayed laryngeal reinnervation using the main branch of the ansa cervicalis in treatment of unilateral vocal fold paralysis (UVFP) caused by thyroid surgery. Summary of Background Data: UVFP remains a serious complication of thyroid surgery. Up...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics