Thyroidectomy under local anaesthesia: experience with giant goitres

Abstract

The first successful thyroidectomy on record appears to have been performed in about 952 A.D. in Zahra, an Arab city of Spain by a Moorish physician, Albucassis. The extirpation of thyroid gland for goiter typifies, perhaps better than any operation, the supreme triumph of the surgeon’s art. More than 80% of thyroid swellings are operated upon primarily for cosmetic reasons. Thyroidectomy is usually performed with general endotracheal anaesthesia. However, in many developing countries, because of the severe shortage of anaesthetists, anaesthetic drugs and equipment it can be done under local anaesthesia with acceptable results. Giant goiter is an enlargement of the thyroid gland not less than 10gm/kilogram body weight. Previous reports of thyroidectomy under local anaesthesia were not for giant goiters. Ajao in 1979 wrote: “up to a certain limit the more prominent the thyroid gland is, the easier it is to remove under local anaesthesia”. This is a prospective study of thyroidectomy done for giant goiters in a semi-urban hospital (Nakowa Hospital, Yauri, Kebbi State, Nigeria). The aim of this study was to determine the feasibility, safety, effectiveness and acceptability of local anaesthesia for thyroidectomy. It was also meant to assess any difficulty or complication specifically associated with the procedure.