R. M. Kholmatov1, F. Murad1, D. J. Monlezun1, E. Kandil1 1Tulane University School Of Medicine,Surgery,New Orleans, LA, USA
Introduction:
Ultrasound guided Fine Needle Aspiration (FNA) biopsy is a crucial method of preoperative diagnosis of thyroid diseases. It is usually well tolerated with utilization of local anesthesia. However, many physicians offer their patients sedation. Herein, we aim to examine the correlation of performing the procedure under sedation and specimen’s adequacy.
Methods:
We performed retrospective review of electronic medical records of patients who underwent ultrasound guided FNA of thyroid nodules by single surgeon over eight years period. Patients’ clinicodemographic characteristics such as age, gender, race, BMI, nodule size, vascularity, anticoagulation status, and cytopathology results were collected. Patients were divided into two groups, sedated and non-sedated.
Results:
Total 1568 thyroid biopsies were performed in 802 patients. Mean age was 52.5±14.5 years and 80.2% of patients were women. Sixty patients requested sedation and underwent biopsies of 96 (6.1%) nodules. There was no statistical difference between sedated and non-sedated groups in regards age, gender, nodule size, nodule vascularity, and anticoagulation status (p>0.05). Non-diagnostic sample rate was 81 (5.5%) in non-sedated group, and 7 (7.3%) in the sedated group (p=0.46). A post-FNA hematoma rate was 8 (0.5%) in the non-sedated group, and 1 (1.04%) in the sedated group (p=0.53).
Conclusion:
Performing FNA of thyroid nodules under sedation is safe but doesn’t improve the non-diagnostic sample rate or post-FNA hematoma rate. Further studies are warranted to decide whether sedation is appropriate in particular hospital settings.