Thyroidectomy Operation Using Cervical Epidural Anesthesia Method in a Case with Pemphigus Vulgaris.

The anesthesia of patients with pemphigus vulgaris (PV) demands special emphasis in relation to the possible formation of bulla in tracheal mucosa following intubation and the consequent postoperative respiration difficulties. We demonstrate our application of cervical epidural anesthesia on a 58 year-old female patient with PV who underwent subtotal thyroidectomy. An 11 cm tuohy needle was inserted between C7-TI and an 18 G epidural catheter were placed under fluoroscopic guidance. During the operation, a total of 20 cc-mixture containing 120 mg lidocaine, 100 µgr fentanyl and saline solution was given through the epidural catheter. Additional 5 mg intravenous midazolam was injected for sedation. The anesthesia level was controlled with the pink prick test. Hemodynamic and respiratory parameters were calculated at preoperative 5th, 10th, 15th, 25th and postoperative 5th minutes. No complication was detected concerning epidural anesthesia. We recommend, therefore, cervical epidural anaesthesia in patients with PV in appropriate cases. [ABSTRACT FROM AUTHOR]