The importance of being awake during the procedure is to be able to tell the operator that there is a problem.
Recent paper by a group of surgeons and endocrinologists had his quote.
“Patients also had additional mild conscious sedation with midazolam and/or fentanyl, and one patient required ketamine, administered by an anesthesiologist who monitored the patients’ hemodynamics throughout the procedure.”
Office based thyroid RFA done by our group of endocrinologists that excludes radiologists and surgeons does not use fentanyl or midazolam, and never uses ketamine administered by a anesthesiologist. We screen the patients for co-morbidity and refuse to put anyone to sleep. We monitor the voice throughout the procedure and have standby iced dextrose to inject around the nerve to aid fast recovery. All possible problems are handled because they are awake and can tell us if they are having pain. We can correct any of the possible the problems ASAP.
One patient developed hoarseness of voice during the procedure and 10 mL of cold D5W was injected in the tracheoesophageal groove with partial improvement in symptoms at the time.
Her voice returned to normal in 6 months. Vocal cord recovery was documented by laryngoscopy and ultrasonography.
The total complication rate was 4.2%.
Was the recurrent nerve injury while the patient was under sedation?
Safety and Efficacy of Radiofrequency Ablation of Thyroid Nodules – Expanding Treatment Options in the United States
Journal of the Endocrine Society, bvab110, https://doi.org/10.1210/jendso/bvab110
Call me at 1-310 393-8860 or [email protected] for evaluation for your thyroid nodule problem and be awake during the procedure. Ask for Alicia.