Intubation manoeuvres in patients undergoing thyroid surgery might be challenging for anesthesiologist. Thyroid gland enlargement (goiter) or tissue fibrosis (neoplasms) could alter the physiologic anatomy of upper airways and trachea, resulting in compression or dislocation. We want to evaluate the incidence and identify predictive parameters of difficult intubation in patients undergoing thyroid surgery.
Intubation manoeuvres in patients undergoing thyroid surgery might be challenging for anesthesiologist. Thyroid gland enlargement (goiter) or tissue fibrosis (neoplasms) could alter the physiologic anatomy of upper airways and trachea, resulting in compression or dislocation. There are few scientific data about airway management and thyroid pathology and the incidence of difficult tracheal intubation in this specific kind of patient is largely variable from 0% to 12.9%. These data have been collected from little statistical samples (from 50 to 326 patients), the results aren't always unanimous and a study evaluating simultaneously all the risk factors for difficult intubation does not exist. We want to evaluate the incidence and identify predictive parameters of difficult intubation in patients undergoing thyroid surgery. During pre-anesthetic assessment the following data will be collected: Inter-incisor gap (cm) Mallampati test (1;2;3;4) Thyromental distance (cm) Prognathism (yes; no) Neck motility (\<80°;80-90°;\>90°) Total body weight (kg) History of difficult tracheal intubation (yes; no) Tracheal deviation at chest X-Ray (yes; no) Neck circumference (cm) Mediastinal goiter (yes; no) Histologic features (benign; carcinoma) During the post-anesthesia it will be noted down the following: Cormack scale (1; 2a; 2b; 3; 4) Number of necessary attempts to intubate (1;2;3;…) Time from induction to intubation (min) Necessity to use advanced airway management devices (Frova; Glidescope; Ambu-scope; fiber-optic; other)
Study Type
OBSERVATIONAL
Enrollment
500
Patient undergoing thyroid surgery
University of Padova
Padova, Italy
Difficult intubation incidence
Difficult intubation described as Cormack 3 or 4
Time frame: through study completion, an average of 2 year
Histologic features (benign; carcinoma) as predictive parameter for difficult intubation
preoperative Histologic features (benign; carcinoma) as predictive parameter for difficult intubation
Time frame: through study completion, an average of 2 year
Neck circumference (cm) as predictive parameter for difficult intubation
preoperative Neck circumference (cm) as predictive parameter for difficult intubation
Time frame: through study completion, an average of 2 year
Tracheal deviation at chest X-Ray (yes; no) as predictive parameter for difficult intubation
preoperative Tracheal deviation at chest X-Ray (yes; no) as predictive parameter for difficult intubation
Time frame: through study completion, an average of 2 year
History of difficult tracheal intubation (yes; no) as predictive parameter for difficult intubation
preoperative History of difficult tracheal intubation (yes; no) as predictive parameter for difficult intubation
Time frame: through study completion, an average of 2 year
Total body weight (kg) as predictive parameter for difficult intubation
preoperative Total body weight (kg) as predictive parameter for difficult intubation
Time frame: through study completion, an average of 2 year
Neck motility (<80°;80-90°;>90°) as predictive parameter for difficult intubation
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preoperative Neck motility (\<80°;80-90°;\>90°) as predictive parameter for difficult intubation
Time frame: through study completion, an average of 2 year
Thyromental distance (cm) as predictive parameter for difficult intubation
preoperative Thyromental distance (cm) as predictive parameter for difficult intubation
Time frame: through study completion, an average of 2 year
Mediastinal goiter (yes; no) as predictive parameter for difficult intubation
preoperative Mediastinal goiter (yes; no) as predictive parameter for difficult intubation
Time frame: through study completion, an average of 2 year
Prognathism (yes; no) as predictive parameter for difficult intubation
preoperative Prognathism (yes; no) as predictive parameter for difficult intubation
Time frame: through study completion, an average of 2 year
Mallampati test (1;2;3;4) as predictive parameter for difficult intubation
preoperative Mallampati test (1;2;3;4) as predictive parameter for difficult intubation
Time frame: through study completion, an average of 2 year
Inter-incisor gap (cm) as predictive parameter for difficult intubation
preoperative Inter-incisor gap (cm) as predictive parameter for difficult intubation
Time frame: through study completion, an average of 2 year