Goitre –related factors for predicting difficult intubation in patients scheduled for thyroidectomy in a resource challenged health institution in north central Nigeria.
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Date
2018
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Publisher
Jimma University, Ethiopia
Abstract
BACKGROUND: Airway management problems may arise when
intubating patients with goitre scheduled for thyroidectomy.
Goitres are not uncommon in sub-Saharan Africa, thyroidectomy
being the main treatment. The aim of this study was to determine
incidences of difficult intubation (DI), failed intubation (FI)and
predictors of DI using a modified intubation difficulty score
(IDS).
METHODS: One hundred and twenty-five consenting patients
with goitre scheduled for thyroidectomy were recruited. Goitrerelated
factors (GRF) of duration of illness, diagnosis, neck
circumference, tracheal deviation and narrowing and retrosternal
extension were recorded as well as Mallampati classification and
BMI. At intubation, modified IDS was determined for each
patient. Patients with modified IDS ≤ 5 were categorized as easy
intubation group (E), and those with modified IDS >5 were
categorized as difficult intubation group (D). The GRF of all
patients in group D were compared with matched patients in
group E.
RESULTS: Incidence of DI was 13.6% with 2 (1.6%) cases of
failed intubation. Comparing groups D and E, duration of illness
was 4.28 ± 3.78 years in group D versus 7.44 ± 7.63 years group
E, p = 0.1353. Neck circumference was 41.42 ±5.30 cm in group
D versus 37.43±2.68 cm in group E, p = 0.0200. Tracheal
deviation, narrowing and retrosternal extension, and surgical
diagnosis were not significantly different among both groups.
CONCLUSION: Incidence of DI was 13.6% and that of FI was
1.6%. Neck circumference was found to be a predictor of difficult
intubation in goitre patients scheduled for thyroidectomy using
the modified IDS.
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Keywords
Goitre, thyroidectomy, difficult intubation, predictive factors, modified intubation difficulty score
Citation
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