None listed
Conditions
Brief summary
Background: The aim of this study was to compare the imaging success of the Macintosh laryngoscope and the Bonfils intubation fiberscope (BIF) when used to assess the vocal cords in the early postoperative period after thyroid surgery. The patients’ comfort and their hemodynamic responses with the respective techniques were also investigated. Methods: Fifty euthyroid patients aged 18–73 years (ASA I-II) undergoing elective thyroid surgery were included in the study. In all cases, a Macintosh blade with an appropriate size was used for intubation during the induction of anesthesia. After extubation, the vocal cords were imaged with the Macintosh laryngoscope and the BIF. The Mallampati classification, the thyromental distance, the sternomental distance, the maximum opening of the mouth, and the circumference and mobility of the neck were recorded in the preoperative period. In the postoperative period, the patients’ Cormack–Lehane scores, their reactivity scores, and their hemodynamic parameters with both the Macintosh laryngoscope and the BIF were recorded. Results: The BIF was significantly more successful in imaging the vocal cords after tracheal extubation than the Macintosh laryngoscope (p=0.000). The patients’ reactivity scores were significantly lower with the BIF when compared to the Macintosh laryngoscope (p=0.000). The mean arterial pressure (MAP) was significantly elevated during Macintosh laryngoscopy compared to Bonfils intubation fiberscopy (p=0.000). Conclusions: In conclusion, the BIF provided better glottal visualization, less patient discomfort, and fewer hemodynamic responses during the assessment of the vocal cords in the early postoperative period after thyroid surgery when compared to the Macintosh laryngoscope.
Interventions
1.Bonfils intubation fiberoscope (karl Storz Co., Tutlingen, Germany) was introduced into clinical practice during the 1980s. It is a rigid, reusable, straight fiberoptic device (40cm in length and 5 mm in diameter), which has a 40 degree curved tip. It includes flexible eyepiece mounted on the handle. Recent studies found that this device was convenient for tracheal intubation in patients with normal airways or in those with predicted airway difficulties. The Macintosh series laryngoscopes are
1.Bonfils intubation fiberoscope (karl Storz Co., Tutlingen, Germany) was introduced into clinical practice during the 1980s. It is a rigid, reusable, straight fiberoptic device (40cm in length and 5 mm in diameter), which has a 40 degree curved tip. It includes flexible eyepiece mounted on the handle. Recent studies found that this device was convenient for tracheal intubation in patients with normal airways or in those with predicted airway difficulties. The Macintosh series laryngoscopes are the predominant model of the curved blade types. During laryngoscopy, the tip or “beak” of the blade is compressed into the angle formed by the base of the tongue and the epiglottis (vallecula), indirectly raising the epiglottis. Macintosh laryngoscope is a device that we use routinely in all intubation procedures. 2. This procedure was performed after 3 minutes of thyroid surgery 3. The duration of the procedure for both devices was 1 minute. 4.The devices were administered to the patients only for one time.
Sponsors
Mustafa Kemal University
Study design
Allocation
Randomised controlled trial
Primary purpose
Diagnosis
Eligibility
Sex/Gender
All
Age
18 Years to 73 Years
Healthy volunteers
No
Inclusion criteria
50 euthyroid patients aged 18-73 years (ASA I-II) undergoing elective thyroid surgery were included in the study
Exclusion criteria
Patients with cardiopulmonary diseases, such as hypertension, coronary artery disease, bronchitis, or asthma, and those with obstructive-sleep apnea syndrome or previous vocal cord dysfunction and difficult intubation were excluded
Outcome results
None listed