Magnitude and Predictors of Difficult Tracheal Intubation in Patients who Underwent Elective Thyroid Surgery at Selected Addis Ababa Public Hospitals, Ethiopia
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Date
2023-08-27
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Addis Ababa University
Abstract
Thyroid surgery has got variety of anesthesia concerns. One of the anesthetic concerns is airway related problems which is difficult tracheal intubations that lead to devastating complications or may increase morbidity and mortality of the patients. Airway assessment can have significant importance to anticipate a difficult airway before anesthetic administration and help us to prepare for treating difficulty and to avoid life-threatening complications related to difficulty in tracheal intubation.
Objective: To assess the magnitude and predictors of difficult tracheal intubations in patients who underwent elective thyroid surgery at selected Addis Ababa public hospitals, Ethiopia, From Dec, 2022 to Mar, 2023.
Methods: A hospital-based multicenter cross-sectional study design was used. The study comprised 196 ASA I and II thyroid patients aged 18 to 65 were included. Descriptive statistics were done on socio-demographic variables to obtain frequency distributions. The analysis was done by using binary logistic regression while data in univariate analysis with p-value < 0.2 was entered into multivariate logistic regression. Finally, variable with p value < 0.05 in multivariate logistic regression is considered statistically significant association with difficult tracheal intubations.
Result: A total of 196 patients were included in the study. From which 26(13.3%) patients had DTI. In addition to these the presence of tracheal deviation on chest x-Ray and increase in mass duration from 161 to 240 month was found to be a strong association with DTI on multivariate logistic regression analysis with (p 0.001, OR=14.4, and p 0.001, OR= 16.4) respectively.
Conclusion and recommendations: We conclude that patients with increased duration of mass and presence of tracheal deviation on chest X-ray have a strong association with difficult tracheal intubation. So that such patients with goiter need thorough pre-operative evaluation as considering duration of the mass and tracheal deviation. We recommend anesthesia professionals to give due attention for thyroid patient with long duration of mass and tracheal deviation to do x-ray as a preoperative test modality for thyroid patients.
KEY WORDS: Difficult tracheal intubation, Intubation difficulty score and Thyroid surgery
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Keywords
Difficult tracheal intubation, Intubation difficulty score and Thyroid surgery