Document Type : Review Article
Authors
1
Department of Anesthesiology, Mazandaran University of Medical Science, Sari, Iran
2
Department of Urology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran
3
Student Research Center, Mazandaran University of Medical Sciences, Sari,Mazandaran, Iran,
4
Mazandaran University of Medical Sciences, Sari, Iran,
5
Student Research Center, Mazandaran University of Medical Sciences, Sari, Iran
6
Student Research Center, Mazandaran University of Medical Sciences, Sari,Mazandaran, Iran
Abstract
Thyroid carcinoma encompasses a heterogeneous group of malignancies, each with distinct biological behaviors, therapeutic strategies, and challenges in pain management and anesthesia. This review delves into the subtypes of thyroid carcinoma—anaplastic, papillary, follicular, Hurthle cell, and medullary—emphasizing the critical interplay between effective pain control and surgical outcomes. Anaplastic thyroid carcinoma (ATC), characterized by rapid progression and local invasion, necessitates multimodal pain management, including systemic analgesics and nerve blocks, to address severe discomfort caused by structural compression. Papillary and follicular thyroid carcinomas, generally indolent but prone to recurrence, require tailored anesthesia and postoperative pain protocols, incorporating techniques like cervical plexus blocks to reduce opioid reliance. Unique challenges are posed by Hurthle cell carcinoma (HCC) and medullary thyroid carcinoma (MTC). HCC, often associated with poor prognosis, demands precise surgical techniques to enhance survival, while MTC involves hereditary and sporadic forms with systemic manifestations complicating pain management. Advanced surgical methods, including transoral and robotic thyroidectomy, are explored for their efficacy in reducing complications and enhancing patient satisfaction. For patients with genetic predispositions, early prophylactic surgeries significantly mitigate risks. Anesthesia considerations are paramount, particularly in advanced ATC, where airway management is crucial. Techniques such as total intravenous anesthesia (TIVA) and regional nerve blocks optimize perioperative outcomes while minimizing systemic side effects. This narrative underscores the importance of interdisciplinary collaboration and individualized care in addressing the multifaceted needs of thyroid carcinoma patients, ultimately aiming to improve survival rates and quality of life.
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