Hypnosis and superficial cervical anesthesia for total thyroidectomy in a high-risk patient – A case report
| Autor: | P. Makovac, M. Matter, L. Pucci, A. Roukain, Peter Kopp, T. Rutz, A. Potié |
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| Rok vydání: | 2020 |
| Předmět: |
Hypnosis
medicine.medical_treatment Sedation Superficial anesthesia Thyroidectomy Article 03 medical and health sciences 0302 clinical medicine Medicine Local anesthesia Tricuspid atresia Associated Pulmonary Arterial Hypertension Total thyroidectomy business.industry food and beverages Atrial fibrillation medicine.disease 030220 oncology & carcinogenesis Anesthesia 030211 gastroenterology & hepatology Surgery medicine.symptom business |
| Zdroj: | International journal of surgery case reports, vol. 72, pp. 133-136 International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Highlights • Total thyroidectomy can be challenging in high-risk patients. • Local superficial anesthesia combined with a hypnosis-analgesia technique instead of intravenous sedation. • Because of difficulties controlling the thyrotoxic state. • Given the multiple cardiac and large vessel malformations, a possible variant of the inferior laryngeal nerve was expected. • Locoregional deep cervical anesthesia can be associated with breathing problems when performed bilaterally. Introduction Total thyroidectomy can be challenging in high-risk patients. Local cervical anesthesia with sedation is an alternative to general anesthesia. Case presentation A 33-year old male patient with cyanotic congenital heart disease due to unrepaired tricuspid atresia type Ic and associated pulmonary arterial hypertension presented with tachycardic atrial fibrillation and amiodarone-induced thyrotoxicosis resulting in recurrent hemodynamic instability. Because of difficulties controlling the thyrotoxic state, the indication for total thyroidectomy was established. Total thyroidectomy was subsequently performed using local anesthesia combined using a hypnosis-analgesia technique instead of intravenous sedation. The intervention and the post-operative course were uneventful. Discussion A well-established therapist-patient relationship is crucial for a successful induction of hypnosis. Patient motivation and expectations are equally important for a successful implementation of this approach. Conclusion We conclude that hypnosis combined with local anesthesia provides an effective alternative in selected patients with very high anesthesiological risk. |
| Databáze: | OpenAIRE |
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