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Anesthesia for Thyroid Surgery
Published in Madan Laxman Kapre, Thyroid Surgery, 2020
Vidula Kapre, Shubhada Deshmukh, Pratibha Deshmukh, Meghna Sarode, Rajashree Chaudhary
Mandibular space determines ease of laryngoscopy and can be evaluated on the basis of thyromental distance, which is the distance between the thyroid notch and symphasis menti when the neck is extended. It should be at least 6 cm.
Positions in neurosurgery
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Essentials of Geriatric Neuroanesthesia, 2019
Zilvinas Zakarevicius, Mikhail Gelfenbeyn, Irene Rozet
To prevent swelling of upper airway, tongue (macroglossia), and cranial nerve damage, excessive head flexion should be avoided. At least 2–3 finger-breadths of thyromental distance should be maintained. Unnecessary foreign bodies in the pharynx (TEE probe, oral airway) may mitigate obstruction of the venous outflow and should be avoided if possible. Properly-sized oral and/or nasogastric tube is not a concern.
Airway assessment
Published in Daniel Cottle, Shondipon Laha, Peter Nightingale, Anaesthetics for Junior Doctors and Allied Professionals, 2018
Thyromental distance. This involves assessment of the distance from the thyroid notch to the tip of the jaw or mentum with the mouth closed and the head maximally extended. This represents the position of the larynx from the tongue base. This normally measures >6.5 cm (or more than three finger breadths); a distance of <6 cm indicates a more difficult intubation.5
Dynamic prediction of hypoxemia risk at different time points based on preoperative and intraoperative features: machine learning applications in outpatients undergoing esophagogastroduodenoscopy
Published in Annals of Medicine, 2023
Zhaojing Fang, Daizun Zou, Weigen Xiong, Hongguang Bao, Xiuxiu Zhao, Chen Chen, Yanna Si, Jianjun Zou
Patients’ clinical data were collected: age; gender; BMI; drinking; ASA class; STOP-BANG score [15]; pre-existing diseases, such as hypertension, diabetes, chronic obstructive pulmonary disease (COPD), and gastrointestinal surgery; hemoglobin and baseline SpO2. Patients with STOP-BANG scores ≥ 3 were defined as at high risk of hypoxemia. Besides, a total airway assessment, including neck circumference, thyromental distance (TMD), thyromental height (TMH), sternomental distance (SMD), inter-incisor distance, modified Mallampati class, etc., was performed by the anesthesiologists before the EGD procedure. Smoking was separated into never, current and quit (never smoking or previously smoked regularly and quit at least one year before admission). Preoperative electrocardiogram was recorded as normal, bradycardia, premature beat, atrial fibrillation, heart block, ST-T change and others. At least two anesthesiologists collected all data in charge of the patients.
Thyromental height test as a predictor of difficult airway. Single test versus multivariate predictive models. A cohort study
Published in Egyptian Journal of Anaesthesia, 2022
Mohamed Ollaek, Shady Abo Elela, Abeer Ahmed, Neamat Abdel Rahman, Gehan ElKholy, Antony Gorgy, Islam Reda, Dina Mohamed
Age, sex, weight, height, and ASA class were noted before surgery. Two researchers who were not engaged in the induction of GA or the evaluation of the laryngoscopic view carried out the five chosen airway tests. Utilising a digital depth gauge (insize manufacturer; India) [10], the height between the thyroid cartilage’s anterior border and the mentum’s anterior border was measured as the thyromental height test (TMHT). During the test, the patients were supine, with their mouths closed and heads kept neutral on a 5–7 cm pillow [10,11]. While the patients were in a supine position, with their mouths closed and necks extended, the thyromental distance (TMD) was measured using a tape as a straight line between the top border of the thyroid cartilage and the bony point of the mentum [11,15]; and the sternomental distance (SMD) was measured as a straight line between the upper border of the manubrium sterni and the bony point of the mentum [15,16]. The patients were then seated with their backs supported and mouths wide open; the Inter-incisor distance (IID) was measured as the distance between the upper and lower incisors in the midline [11]. Then, the appropriate Modified Mallampati test (MMT) class was recorded [16].
A comparison of endotracheal intubation characteristics between Macintosh, CMAC, and Smart Trach Video laryngoscope: a randomized prospective clinical trial
Published in Expert Review of Medical Devices, 2022
Rudrashish Haldar, Ashish Kumar Kannaujia, Rafat Shamim, Prabhaker Mishra
After obtaining clearance from the Institute Ethics Committee (2019–116-IP-109) and registering the trial in Clinical Trial registry of India (CTRI/2019/09/021279 dated 17/09/2019), this prospective, single blind, randomized trial was conducted between 3/10/2019 to 29/5/2020 and enrolled 375 patients (Figure 3: CONSORT Statement). Inclusion criteria for the study consisted of patients between 18–65 years, belonging to ASA I&II, of either gender who were scheduled for elective surgery. Patients refusing to participate, anticipated difficult airway (Mallampati Class III and IV, thyromental distance <6 cm; and inter-incisor distance <3.5 cm), Obesity (BMI >35 kg/ m2), increased intracranial pressure or cervical spine diseases, cardiovascular disease, endocrine diseases and patients with presence of risk factors for gastric aspiration, e.g. pregnancy, diabetes, etc were excluded from the study. After briefing about the study protocol, willing patients were recruited after obtaining written informed consent in English or Hindi. Enrolled patients were treated with high ethical standards in accordance to the Declaration of Helsinki