Intubation;Difficult Clinical Trial
Official title:
Predictive Parameters for Difficult Tracheal Intubation Identification in Thyroid Surgery, a Observational Monocentric Prospective Study
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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