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To compare the efficacy and safety of intravenous anesthesia (IV) with local anesthesia (LA) in patients undergoing ultrasound (US)-guided radiofrequency ablation (RFA) of thyroid nodules. 50 patients with American Society of Anesthesiologists classification grades I–II undergoing US-guided thyroid RFA were enrolled and randomly (1:1) divided into IV (conscious sedation with Ramsay Sedation Scale [RSS] scores of 2–3 with an anesthesiologist) and LA (subcutaneous anesthesia with lidocaine without an anesthesiologist) groups. Pre-, intra- and post-procedural blood pressure (BP) (SBP 0 /DBP 0 , SBP 1 /DBP 1 , and SBP 2 /DBP 2 ), intra- and post-procedural pain (NRS 1  and NRS 2 ), ablated area volume, treatment time and adverse events were analyzed and compared. Age, sex, weight, number, nature, volume of nodules, and SBP 0 /DBP 0  showed no difference between both groups. 11 and 0 patients’ SBP 1 /DBP 1  were elevated in the LA and IV groups. NRS 1  differed between both groups. 6 patients in the LA group had moderate or severe pain, but none in the IV group. No between-group difference in SBP 2 /DBP 2 , NRS 2 , ablation completion rate and ablated volume was noted. The median procedure duration differed from 1109 (176) s in IV group and 723 (227) s in LA groups. There was no increased incidence of adverse events in IV group. IV with RSS scores of 2–3 maintained intra-procedural BP and relieved intra-procedural pain better, without affecting the ablation efficacy and increasing complications. Despite increased treatment time, IV is a potential option for patients undergoing US-guided RFA of thyroid nodules.

international journal of hyperthermia

Different effects of intravenous and local anesthesia in patients undergoing ultrasound-guided radiofrequency ablation of thyroid nodules: a prospective cohort study