A faster parathyroidectomy: Techniques to shorten non-surgical operating room time.

Am J Otolaryngol

Department of Otolaryngology - Head and Neck Surgery, Henry Ford Health System, 2700 West Grand Boulevard, Detroit, MI 48202, United States of America. Electronic address:

Published: April 2020

AI Article Synopsis

  • The study evaluated how different techniques, specifically monitored anesthesia care (MAC) and the use of a second peripheral intravenous catheter (PIV), affect non-operative times during parathyroid surgery.
  • Researchers conducted a retrospective analysis of surgeries performed between 2013 and 2016, comparing operating room time measurements such as pre-incision and post-closure times.
  • Results showed that MAC led to significantly shorter pre-incision, post-closure, and total operative times compared to general anesthesia, and that using a second PIV also reduced these times.

Article Abstract

Objective: To assess the capacity of different techniques to reduce non-operative times during parathyroid surgery. The impact of monitored anesthesia care (MAC) instead of general anesthesia, and the pre-operative placement of a second peripheral intravenous catheter (PIV) were analyzed.

Methods: A retrospective case series at an academic medical center was performed to study patients undergoing parathyroidectomy by a single surgeon between November 2013 and October 2016. Three operating room (OR) time measurements were compared: pre-incision time, post-closure time, and total OR time.

Results: Surgeries performed under MAC (n = 21) had statistically shorter pre-incision (33.2 min vs. 39.7 min, p < .001), post-closure (10.1 min vs. 16.2 min, p = .002), and total operative times (113.0 min vs. 151.5 min, p < .001) compared to those in which general anesthesia (n = 169) was used. Of the 169 patients who underwent general anesthesia, 25 had a second PIV placed preoperatively and 144 had only a single PIV. All 3 time periods were statistically shorter in patients who had a second PIV versus those who had only a single PIV (pre-incision 32.2 min vs. 41.0 min, p < .001; post-closure 12.2 min vs. 16.9 min, p < .001; total 117.9 min vs. 157.4 min, p < .001).

Conclusions: In patients undergoing parathyroid surgery in which ioPTH levels will be used, the placement of a second PIV in the pre-operative holding area and performance of surgery under MAC can significantly shorten non-operative and total OR time.

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Source
http://dx.doi.org/10.1016/j.amjoto.2019.102292DOI Listing

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