Chawaka Hunduma Jisha, Teshome Zenebe Bekele
Ambo University, Anesthesiology, Ambo, Ethiopia.
Anesthesiol Res Pract. 2023 Aug 7;2023:1312980. doi: 10.1155/2023/1312980. eCollection 2023.
Postoperative voice change, difficulty of swallowing, throat pain, and neck pain are the most commonly complaint after thyroid surgery. However, little emphasis is given to the problem, especially a place where the surgical and anesthesia services' unmet need is highly observed, i.e., the problem gets little attention especially in the countries where the gaps of surgery and anesthesia services are observed. Hence, this study aims to determine the magnitude and associated factors of voice change and related complaints after thyroid surgery.
A cross-sectional study was conducted on 151 patients who had had thyroid surgery from June 1 to December 30, 2021. Data were retrieved during the postoperative period after the patient regains consciousness.
Out of 151 participants, 98 (64.9%) patients complained of either voice change or difficulty of swallowing and neck pain after thyroid surgery within 24 hours. Majority (58.3%) of the participants aged more than 30 years with a mean age of 33.7 ± 8.3 years and females 102 (67.5%). Neck pain is the most (52.3%) complained suffering after thyroid surgery, followed by voice change 38.4% and difficulty in swallowing 37.7%. Difficulty in swallowing after thyroid surgery significantly associated with a patient who frequently experience intraoperative hypotension (AOR = 23.24, 95% CI 4.6-116.7, and = 0.01), type of surgical procedure (total thyroidectomy) (AOR = 8.62, 95% CI 1.21-61.50, and = 0.03), and larger ETT size (AOR = 4.92, 95% CI 1.34-18.01, and = 0.02). Postoperative voice change is associated with larger endotracheal tube (AOR = 15.47, 95% CI 3.4-69.5, and ≤ 0.001), surgery lasting more than 2 hours (AOR = 7.34, 95% CI 1.5-35.1, and = 0.01), and intraoperative hypotension (AOR = 23.24, 95% CI 4.6-116.7, and ≤ 0.001).
The complaint of postthyroidectomy neck pain and throat discomfort is higher than 64.9%. Intraoperative hypotension, blood loss, higher ETT size utilization, and duration of surgical procedure are the identified possible risk factors and have to be minimized as much as possible. Patient reassurance has to be considered during the postoperative time.
术后声音改变、吞咽困难、咽痛和颈部疼痛是甲状腺手术后最常见的主诉。然而，这个问题很少受到重视，尤其是在外科手术和麻醉服务未满足需求情况严重的地区，也就是说，在那些存在手术和麻醉服务差距的国家，这个问题尤其不受关注。因此，本研究旨在确定甲状腺手术后声音改变及相关主诉的严重程度和相关因素。
对2021年6月1日至12月30日期间接受甲状腺手术的151例患者进行了横断面研究。在患者术后苏醒后的恢复期收集数据。
151名参与者中，98名（64.9%）患者在甲状腺手术后24小时内出现声音改变、吞咽困难或颈部疼痛。大多数（58.3%）参与者年龄超过30岁，平均年龄为33.7±8.3岁，女性102名（67.5%）。颈部疼痛是甲状腺手术后最常出现的主诉（52.3%），其次是声音改变（38.4%）和吞咽困难（37.7%）。甲状腺手术后吞咽困难与经常术中低血压的患者显著相关（调整后比值比[AOR]=23.24，95%置信区间[CI]4.6 - 116.7，P = 0.01）、手术方式（全甲状腺切除术）（AOR = 8.62，95% CI 1.21 - 61.50，P = 0.03）以及较大的气管内导管尺寸（AOR = 4.92，95% CI 1.34 - 18.01，P = 0.02）有关。术后声音改变与较大的气管内导管（AOR = 15.47，95% CI 3.4 - 69.5，P≤0.001）、手术持续时间超过2小时（AOR = 7.34，95% CI 1.5 - 35.1，P = 0.01）以及术中低血压（AOR = 23.24，95% CI 4.6 - 116.7，P≤0.001）有关。
甲状腺切除术后颈部疼痛和咽喉不适的主诉率高于64.9%。术中低血压、失血、较大气管内导管尺寸的使用以及手术持续时间是已确定的可能危险因素，必须尽可能将其降至最低。术后必须考虑对患者进行安抚。
