Effetcs of 2%lidocaine local blocking around parat hyroid gland on IHP after thyroidectomy

YI Zhefu; LI Sanrong

doi:10.3969/j.issn.1002-7386.2017.23.005

Abstract：Objective To investigate the effects of 2% lidocaine local blocking around parathyroid gland during thyroid surgery on hypoparathyroidism after thyroidectomy in order to provide reference for clinical treatment .Methods A total of 143 patients who underwent thyroid surgery were randomly divided into control group ( n=70 ) and observation group ( n=73 ) .The patients in control group were treated by receiving meticulous capsular dissection technique , however , the patients in observation group ,on the basis of control group ,were given 2%lidocaine local blocking around parathyroid gland . After operation the serum levels of calcium ,phosphorus,parathyroid hormone (PTH) before operation and on 1h,1d,3d after operation were observed and compared between the two groups .After 6-month follow up , the incidence rates of IHP and hypocalcemia were observed and compard between two groups .Results The levels of PHT,serum calcium on 1h,1d,3d after operation in observation group were significantly higher than those in control group ,however,the levels of serum phosphorus were significantly higher than those in control group (P<0.05).The levels of PHT, serum calcium in lobectomy and isthmus resection combined with ipsilateral central lymph node dissection group , total thyroidectomy group , total thyroidectomy combined with ipsilateral central lymph node dissection group were significantly lower than those in simple lobectomy and isthmus resection group ,however , the levels of serum phosphorus were significantly higher than those in simple lobectomy and isthmus resection group (P <0.05).On 1d after operation, the levels of PHT,serum calcium in lobectomy and isthmus resection combined with ipsilateral central lymph node dissection , total thyroidectomy , total thyroidectomy combined with ipsilateral central lymph node dissection in observation group were significantly higher than those in control group with the same operation types ,however , the levels of serum phosphorus were significantly lower than those in simple lobectomy and isthmus resection hroup (P <0.05).After 6-month follow up,the incidence rates of hypoparathyroidism ,hypocalcemia in observationgroup were significantly lower than those in control group ( P<0.05 ) .Conclusion On the basis of protecting parathyroid glands by means of intraoperative parathyroid membrane dissection method ,the 2%lidocaine local blocking around parathyroid glands can effectively protect parathyroid function and obviously reduce the incidence of hypoparthyroidism , therefor,which is worth paying much attention to .