Background and Objective: Minimal invasive parathyroidectomy under local anesthesia with sedation has the same cure rates as the general anesthesia but has better postoperative complications control. The objective of the study was to justify the hypothesis that levobupivacaine infiltration and midazolam sedation technique is effective in minimally invasive parathyroidectomy. Materials and Methods: Total, 248 patients who had clinically confirmed primary hyperparathyroidism were included in a trial. Patients had received intravenous propofol (PI group, n = 124) or infiltrated preoperatively by levobupivacaine with midazolam sedation (LM group, n = 124) followed image-guided minimal invasive parathyroidectomy by an ENT surgeon. Postoperative pain, anesthesia-emergent adverse effects, surgical cure and length of hospital stay were recorded. Results: Cure rate was equal in both groups (96 vs. 95%). Hospitalization was fewer in patients of LM group (1.81 +/- 0.11 days) than those of PI group (2.36 +/- 0.21 days, p<0.0001, q = 40.59). Overall satisfaction of patients was strongly in favor of levobupivacaine infiltration with midazolam sedation than propofol-based general anesthesia (VAS score 3.11 +/- 0.41 vs. 5.46 +/- 1.12, p<0.0001, q = 37.87). Patients of PI group had required higher intravenous pain medication (32.12 +/- 4.15 mg vs. 19.11 +/- 2.12 mg morphine/morphine equivalent, p< 0.0001, q = 36.712) and more numbers of anti-emetic doses than LM group. Conclusion: Preoperative levobupivacaine infiltration with midazolam sedation technique was effective and had high advantages in minimally invasive parathyroidectomy.
[1]Jilin Univ, China Japan Union Hosp, Dept Anesthesiol, Changchun 130033, Jilin, Peoples R China.
(8.0+极速模式)