A case series of cervical epidural anaesthesia for large goitre surgeries in camp settings.

Cervical epidural anaesthesia was given in 10 euthyroid patients in a thyroidectomy camp. The epidural catheter was placed in the C7-T1 interspace directed 2-3cm cephalad in sitting position. 10 ml of 0.25% Bupivacaine was injected. Every patient was given supplemental superficial cervical plexus block with Lignocaine-Adrenaline1%(1:400,000), 10 ml on either side. Sensory block was tested with pin prick. 1mg midazolam was used for anxiolysis. Catheter was removed at the end of the surgery taking into consideration camp settings.

Surgical analgesia was satisfactory in all patients. 5 patients required 5ml top-up of the same drug after 90 minutes. No patient required emergency airway management, in the form of intubation or any airway gadgets. No patient showed any untoward derangement in vitals and respiration. Every patient was followed post-operatively for any respiratory distress.

It is a promising and reliable technique for thyroidectomy in camp setting. It is advantageous for recurrent laryngeal nerve function monitoring, airway monitoring and a good operative field, too. It can be used for extended post-operative analgesia and helpful in settings where equipments and peri-operative facilities are insufficient.