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NCP Acute Pain related to Postoperative Thyroidectomy

Thyroidectomy is the surgical removal of the thyroid gland. The surgical procedure of thyroidectomy involves a partial or a complete removal of the thyroid (a gland, which is located in front of the lower neck, just above the trachea). The gland is formed by two cone-like lobes or wings (lobus dexter (right lobe) and lobus sinister (left lobe), and attached by a middle part (isthmus).
The surgery may be recommended for a variety of conditions including:
An overactive thyroid gland that produces extremely high levels of thyroid hormones A growth (nodule or cyst) associated with the thyroid gland Cancer of the thyroid A small thyroid growth Malignant (cancerous) thyroid tumors Benign (noncancerous) tumors of the thyroid that are causing symptoms An enlarged thyroid gland (nontoxic goiter) that makes it hard for you to breathe or swallow.

Indications for Thyroidectomy:
  • A large goiter that is unlikely to react anti-thyroid drugs, may require surgery of the thyroid gland, to avoid pressure on the trachea and esophagus, which then can cause difficulty breathing and swallowing, respectively.
  • Side effects of drug therapy or adherence to taking medication Persistent poor or non-response to radioactive iodine therapy, up to repeated episodes of hyperthyroidism require excision of the thyroid gland.
  • Thyroidectomy used to negate the need for radioactive iodine therapy, especially in children.
    In pregnant women, when drug therapy fails to control hyperthyroidism, thyroid operation organized
  • Violence and tumors of the thyroid gland require surgical excision.
  • It is also advisable in the case of clinical manifestations such as the rapid growth of the thyroid gland, severe pain, and cervical lymphadenopathy, or when there have been prior to irradiation of the neck. A fine needle aspiration cytology (FNAC) need to preformed to confirm the diagnosis and determine the type of operation.
  • Functionally or anatomically benign goiter, causing much anxiety among patients and is preferred to cut surgery for cosmetic reasons.

Common occurrence after Thyroidectomy
  • There will be episodes of pain, swelling, and bruising around the wound area.
  • Voice may be hoarse. But, this is usually temporary and tone of voice to get back to normal after a few days.
  • During the first few days, eating and drinking can be associated with some discomfort and pain.
  • You will feel a bit sluggish and tired after the surgery.
  • Area can be washed after 7 to 10 days.
  • Light jobs can be done after a period of 2 weeks.

Action to reduce the Acute Pain related to postoperative thyroidectomy
1. Study the presence of pain symptoms, both verbal or nonverbal, note the location, intensity (scale of 0-10), and duration.
Rationale: useful in evaluating pain, determine the choice of interventions to determine effectiveness of therapy.
2. Give patients in semi-fowler’s position and support the head / neck with a small pillow.
Rationale: prevent hyper-extension neck and protect the integrity of the suture line.
3. Suggest patients use relaxation techniques, such as imagination, soft music, progressive relaxation.
Rationale: help to refocus attention and help patients to cope with pain / discomfort more effectively.
4. Give & evaluation prescribed analgesic effectiveness.
Rationale: Analgesics should be at great pains to block pain.

Read More : http://nandanursing.com/acute-pain-related-to-postoperative-thyroidectomy.html

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