Articles: cations.
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Case Reports
Aphonia Following Bilateral Cervical Plexus Blocks for an Awake Hemithyroidectomy: A Case Report.
A 35-year-old female patient was scheduled for a left hemithyroidectomy. We performed bilateral cervical plexus blocks with ultrasound guidance for an awake thyroidectomy. ⋯ After an uneventful surgery, the patient spontaneously regained her normal voice in the postoperative period. The case report describes a previously unreported complication of aphonia presumably due to bilateral recurrent laryngeal nerve blocks, which might have occurred from the infiltrated local anesthetic extravasating to the deeper planes through the cervical fascia.
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In order to prevent short-term complication, patients with frailty syndrome require special attention and care in the perioperative context. The implementation of a frailty screening and if possible, an advanced geriatric assessment in the clinical routine should take into account the clinical setting, the patient population as well as time and human resources. ⋯ Key aspects of such pathways include physiotherapeutic interventions, nutritional counselling, adequate pain medication, delirium prevention, patient blood management and extended perioperative monitoring. An interdisciplinary shared decision-making process together with patients can help develop realistic and individual treatment concepts to improve safety and outcome of frail patients.