Thyroidectomy under local anaesthesia at a medical mission in a poor rural community: A safe alternative in selected patients

Abstract

Background: Surgical missions have become regular in rural sub Saharan Africa, and these have helped to cater for surgical needs in these areas. Major surgeries are often performed in these areas amidst poor facilities for evaluation and treatment. Careful patient selection for thyroidectomy under local anaesthesia results in good surgical outcomes, and these can be replicated successfully with great care in these rural settings.
Methodology: A descriptive study of thyroidectomies done under local anaesthesia in select patients during a 2-week medical mission by Pro-Health International in Weala, Liberia. Twelve patients presented with goitres, with ages ranging from 28 to 80 yrs. Inclusion criteria for selecting patients for surgery were those undergoing first time neck surgery, small or moderate sized goiters without toxic or malignant features, sleeping pulse of less than 80 and American Society of Anaesthesiologists Physical Status (ASA-PS) I and II.
Results: Only 3 patients out of the 12 patients met the criteria. They all had subtotal thyroidectomy done successfully under local anaesthesia. One patient with moderate goitre received whole blood transfusion for primary haemorrhage. The postoperative period was uneventful.
Conclusion: With proper selection, thyroidectomy under local anaesthesia can be useful and effective in a poor healthcare facility.