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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)
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Thyroid surgery | Patient undergoing thyroid surgery |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Thyroid surgery | Other | Patient undergoing thyroid surgery |
|
| Measure | Description | Time Frame |
|---|---|---|
| Difficult intubation incidence | Difficult intubation described as Cormack 3 or 4 | through study completion, an average of 2 year |
| Measure | Description | Time Frame |
|---|---|---|
| Histologic features (benign; carcinoma) as predictive parameter for difficult intubation | preoperative Histologic features (benign; carcinoma) as predictive parameter for difficult intubation | through study completion, an average of 2 year |
| Neck circumference (cm) as predictive parameter for difficult intubation |
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Inclusion Criteria:
Exclusion Criteria:
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patients undergoing thyroid surgery
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Padova | Padova | 35127 | Italy |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 16278626 | Background | Petrini F, Accorsi A, Adrario E, Agro F, Amicucci G, Antonelli M, Azzeri F, Baroncini S, Bettelli G, Cafaggi C, Cattano D, Chinelli E, Corbanese U, Corso R, Della Puppa A, Di Filippo A, Facco E, Favaro R, Favero R, Frova G, Giunta F, Giurati G, Giusti F, Guarino A, Iannuzzi E, Ivani G, Mazzon D, Menarini M, Merli G, Mondello E, Muttini S, Nardi G, Pigna A, Pittoni G, Ripamonti D, Rosa G, Rosi R, Salvo I, Sarti A, Serafini G, Servadio G, Sgandurra A, Sorbello M, Tana F, Tufano R, Vesconi S, Villani A, Zauli M; Gruppo di Studio SIAARTI "Vie Aeree Difficili"; IRC e SARNePI; Task Force. Recommendations for airway control and difficult airway management. Minerva Anestesiol. 2005 Nov;71(11):617-57. No abstract available. English, Italian. | |
| 18946426 |
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Probably all IPD will be shared at the end of the study
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| ID | Term |
|---|---|
| D013959 | Thyroid Diseases |
| ID | Term |
|---|---|
| D004700 | Endocrine System Diseases |
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preoperative Neck circumference (cm) as predictive parameter for difficult intubation |
| 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 | 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 | 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 | through study completion, an average of 2 year |
| Neck motility (<80°;80-90°;>90°) as predictive parameter for difficult intubation | preoperative Neck motility (<80°;80-90°;>90°) as predictive parameter for difficult intubation | 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 | 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 | 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 | 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 | 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 | through study completion, an average of 2 year |
| Background |
| Frova G, Sorbello M. Algorithms for difficult airway management: a review. Minerva Anestesiol. 2009 Apr;75(4):201-9. Epub 2008 Oct 23. |
| 15271749 | Result | Bouaggad A, Nejmi SE, Bouderka MA, Abbassi O. Prediction of difficult tracheal intubation in thyroid surgery. Anesth Analg. 2004 Aug;99(2):603-6, table of contents. doi: 10.1213/01.ANE.0000122634.69923.67. |
| 17000813 | Result | Amathieu R, Smail N, Catineau J, Poloujadoff MP, Samii K, Adnet F. Difficult intubation in thyroid surgery: myth or reality? Anesth Analg. 2006 Oct;103(4):965-8. doi: 10.1213/01.ane.0000237305.02465.ee. |
| 25925037 | Result | Meco BC, Alanoglu Z, Yilmaz AA, Basaran C, Alkis N, Demirer S, Cuhruk H. Does ultrasonographic volume of the thyroid gland correlate with difficult intubation? An observational study. Braz J Anesthesiol. 2015 May-Jun;65(3):230-4. doi: 10.1016/j.bjane.2014.06.004. Epub 2014 Oct 16. |
| 21381580 | Result | Khan MN, Rabbani MZ, Qureshi R, Zubair M, Zafar MJ. The predictors of difficult tracheal intubations in patients undergoing thyroid surgery for euthyroid goitre. J Pak Med Assoc. 2010 Sep;60(9):736-8. |