Predictive Parameters for Difficult Tracheal Intubation Identification in Thyroid Surgery
Study Details
Study Description
Brief Summary
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.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Detailed Description
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 Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Thyroid surgery Patient undergoing thyroid surgery |
Other: Thyroid surgery
Patient undergoing thyroid surgery
|
Outcome Measures
Primary Outcome Measures
- Difficult intubation incidence [through study completion, an average of 2 year]
Difficult intubation described as Cormack 3 or 4
Secondary Outcome Measures
- Histologic features (benign; carcinoma) as predictive parameter for difficult intubation [through study completion, an average of 2 year]
preoperative Histologic features (benign; carcinoma) as predictive parameter for difficult intubation
- Neck circumference (cm) as predictive parameter for difficult intubation [through study completion, an average of 2 year]
preoperative Neck circumference (cm) as predictive parameter for difficult intubation
- Tracheal deviation at chest X-Ray (yes; no) as predictive parameter for difficult intubation [through study completion, an average of 2 year]
preoperative Tracheal deviation at chest X-Ray (yes; no) as predictive parameter for difficult intubation
- History of difficult tracheal intubation (yes; no) as predictive parameter for difficult intubation [through study completion, an average of 2 year]
preoperative History of difficult tracheal intubation (yes; no) as predictive parameter for difficult intubation
- Total body weight (kg) as predictive parameter for difficult intubation [through study completion, an average of 2 year]
preoperative Total body weight (kg) as predictive parameter for difficult intubation
- Neck motility (<80°;80-90°;>90°) as predictive parameter for difficult intubation [through study completion, an average of 2 year]
preoperative Neck motility (<80°;80-90°;>90°) as predictive parameter for difficult intubation
- Thyromental distance (cm) as predictive parameter for difficult intubation [through study completion, an average of 2 year]
preoperative Thyromental distance (cm) as predictive parameter for difficult intubation
- Mediastinal goiter (yes; no) as predictive parameter for difficult intubation [through study completion, an average of 2 year]
preoperative Mediastinal goiter (yes; no) as predictive parameter for difficult intubation
- Prognathism (yes; no) as predictive parameter for difficult intubation [through study completion, an average of 2 year]
preoperative Prognathism (yes; no) as predictive parameter for difficult intubation
- Mallampati test (1;2;3;4) as predictive parameter for difficult intubation [through study completion, an average of 2 year]
preoperative Mallampati test (1;2;3;4) as predictive parameter for difficult intubation
- Inter-incisor gap (cm) as predictive parameter for difficult intubation [through study completion, an average of 2 year]
preoperative Inter-incisor gap (cm) as predictive parameter for difficult intubation
Eligibility Criteria
Criteria
Inclusion Criteria:
- thyroid surgery
Exclusion Criteria:
- <18 years
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | University of Padova | Padova | Italy | 35127 |
Sponsors and Collaborators
- University of Padova
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
- Frova G, Sorbello M. Algorithms for difficult airway management: a review. Minerva Anestesiol. 2009 Apr;75(4):201-9. Epub 2008 Oct 23. Review.
- Petrini F, Accorsi A, Adrario E, Agrò 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. English, Italian.
- 4133/AO/17