Why Thyroid RFA Should be done with the patient awake.

Why Thyroid RFA Should be done with the patient awake.

Why Thyroid RFA Should be done with the patient awake.

  1. Use of a local to the thyroid capsule is all that is needed to control pain.
The pericapsular space in black in front of the needle and wide after lidocaine injection.
  1. The capsule has sensory nerve endings.The interior of the thyroid and nodules have no sensory nerves.
  2. The patient when awake can tell the operator if they have pain, and questions about the voice can be answered.
  3. The finding of a voice change during the procedure is an emergency.
  4. Ice cold dextrose water should be given as a bolus.If the voice returns the operator can continue the ablation.
  5. If there is no improvement continue the infusion until recovery.
  6. 80% recover during the procedure. Steroid injection in the area can help inflammation.
  7. Chung SR et al Int.J.Hypertheria 2019 36(1) p.204. Recurrent nerve, Sympathetic ganglia and Vagus nerves recovered faster with cold D5W. 5 days vs 55 days without the iced dextrose infusion.
  8. The iced dextrose needs to be on the cart when doing thyroid RFA.
  9. Call me at 310-393-8860 or [email protected] for all procedures that use RFA to treat nodules, cancer and parathyroid adenoma.
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