Anesthesia for primary hyperparathyroidism.

We review the anesthesia used on patients with primary hyperparathyroidism from 1980-1989. As the first choice, nearly two thirds of the operations were performed under cervical epidural block, and about 90% of these obtained satisfactory results. Injury of the spinal cord and nerve root could be avoided by accurate insertion of the epidural needle. Respiratory depression might also be minimized with an alert perioperative course of 5 ml 0.8-1.33% lidocaine as the initial dose followed by 6-8 ml for maintenance. For complicated cases, such as those who had undergone previous cervical operations or were suspected of having ectopic parathyroidomas, general anesthesia was carried out instead.