Local anesthesia in MIT

Thyroid and parathyroid surgery was historically performed under local anesthesia. Due to the significant morbidity and mortality of general anesthesia and the absence of adequate medications for hyperthyroid conditions, local anesthesia was widely used to safely manage elderly and medically compromised patients and those with complicated thyrotoxicosis and large goiters (Spanknebel et al. 2005). Sir Thomas Peel (TP) Dunhill, in 1912, is generally credited with being the first surgeon to use local anesthesia for thyroid surgery (Dunhill 1912). As anesthesiologist experience grew and safe general anesthesia techniques were developed and refined, the practice of local anesthesia for thyroid surgery receded. During this time, local anesthesia in thyroid surgery was primarily being used in centers outside of the United States as a necessity rather than choice (i.e., lack of adequate resources or trained personnel, inability to provide postoperative care for critically ill patients (Spanknebel et al. 2005).