Intravenous Sedation and Analgesia Versus Local Anesthesia During Microwave Ablation of Benign Thyroid Nodules

The participants will be randomized into 2 equal groups by a computer-generated random numbers table, named group A and B. An independent data manager of computer-generated software will be responsible for randomization, assigning the participants to the groups using sequentially numbered, sealed, opaque envelopes containing computer-generated random numbers, accessible only to the anesthesiologist. The subjects will be randomly allocated to one of the two groups. Group A: The participants will receive moderate to deep sedation. Group B: The participants will receive perithyroidal local anesthesia. History taking, clinical examination, and routine laboratory investigation will be performed preoperatively, and the participants will be instructed to fast for 6 hours preoperatively for solids and 2 hours for clear fluids. On arrival at the operation room, intravenous access will be established. ECG, noninvasive blood pressure, and arterial oxygen saturation will be monitored routinely. The Numerical Rating Scale (NRS) will be used to assess pain intensity. Preoperatively, all study subjects will be trained to use NRS pain scores. In the intervention radiology room, a peripheral 20 G intravenous (IV) cannula will be inserted. The baseline parameters of five lead electrocardiogram (ECG), noninvasive blood pressure, and peripheral oxygen saturation will be recorded. A nasal oxygen cannula will be applied with a flow of 3 L/min. In group A, participants will receive drugs resulting in moderate to deep sedation, tailored to the specific portions of the procedure, which may offer potential benefits. This approach could provide participants with a potentially painless experience by utilizing moderate sedation during needle placement and deep sedation during the ablation phase. Additionally, this combination approach may minimize the risk of respiratory depression (which can be associated with TIVA and deep sedation) while promoting rapid recovery. The participants will r