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The Rigid Tube as an Alternative in Controlling the Problematic Airway
Published on: June 6, 2020
Effect of silicone and PVC tube intubation on postoperative sore throat after thyroid surgery: a randomized
Die Qiu1,2, Bin Gu2, Siqun Xiao1,2
1Postgraduate Training Base Alliance of Wenzhou Medical University (Zhejiang Cancer Hospital), Hangzhou, Zhejiang, 310022, China.
Background:
Postoperative sore throat (POST) is a complication that occurs with high prevalence following thyroid surgery. Compared with polyvinyl chloride (PVC) tracheal tubes, silicone tubes offer greater flexibility, which may help reduce trauma to the airway mucosa. The purpose of this study was to compare the effect of using silicone or PVC tracheal tubes in thyroid surgery on the incidence of POST within 24 h postoperatively.
Methods:
A total of 182 ASA I-II patients, aged 18-80 years, and undergoing thyroid surgery were included in this study. Patients were randomly assigned to either a silicone (n = 91) or PVC (n = 91) tracheal tube group. The primary outcome was the incidence of POST within the first 24 h postoperatively defined as at least one episode of POST (score ≥ 1). POST was evaluated using a 4-point scale (0 = none, 1 = mild, 2 = moderate, 3 = severe). Secondary outcomes comprised postoperative hoarseness incidence and severity assessed at at 1, 6, and 24 h postoperatively, along with occurrences of dizziness, cough, postoperative nausea and vomiting (PONV), bronchospasm, and laryngospasm.
Results:
Patients in both groups (silicone group = 89, PVC group = 91) had comparable baseline characteristics. The incidence of POST within 24 h was 79% in the silicone group and 90% in the PVC group (Odds ratio [OR]: 0.40, 95% Confidence interval [CI]: 0.17 to 0.95), p = 0.034. The incidence and severity of hoarseness 1 h after surgery was lower in the silicone group, with a statistically significant difference (OR: 0.12, 95% CI 0.02 to 0.96), p = 0.044. However, no differences were observed at 6 and 24 h postoperatively. There were also no significant differences in dizziness, cough, PONV, bronchospasm and laryngospasm within 24 h postoperatively.
Conclusion:
In conclusion, the silicone group demonstrated a lower incidence of POST within 24 h following thyroid surgery compared to the PVC group.
Trial Registration:
Registered in the Chinese Clinical Trial Registry, identifier: ChiCTR2400089978. Date: 09/20/2024.
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