Anesthesia for Transoral Endoscopic Parathyroidectomy by Vestibular
Approach (TOEPVA)
Abstract
Introduction: After thyroid diseases, hyperparathyroidism is one of the
most common endocrine surgical disease. The increasing diagnosis of
thyroid pathologies in early stages and a societal emphasis on physical
appearances, especially in young women, have been led to development of
new surgical techniques alternative to conventional transcervical
incision consistently. Here, we describe our anaesthesia experience for
parathyroidectomy with Transoral Endoscopic Parathyroidectomy by
Vestibular Approach (TOEPVA). Material-method: Patients undergo TOEPVA
at the Health Sciences University Izmir Bozyaka Training and Research
Hospital between November 2018 and April 2019 were reviewed. Demographic
data and hemodynamic parameters were reported. Seven patients were
operated successfully by this technique none of which required
conversion to conventional open surgery. Two patient required atropine
and one patient required ephedrine during insufflation. Conclusion:
After induction of anaesthesia with propofol, remifentanil and
rocuronium; anaesthesia managed by desflurane co-administered with
continous infusion of remifentanil, provide feasible and safe
anaesthesia for TOEPVA. However, especially during hydrodissection and
insufflation, a close cooperation between surgeon and anaesthetist have
a great value to improve patient management.