MedPath

Open Thyroid Surgery With Pillow Versus no Pillow for Better Post-operative Outcomes

Not Applicable
Completed
Conditions
Post-operative Pain
Interventions
Procedure: Extended neck with standard support or pillow
Registration Number
NCT01620151
Lead Sponsor
The University of Hong Kong
Brief Summary

Primary: To compare the post-operative pain in patients with neck extension and without neck extension.

Secondary: To determine the benefit of neck exposure and peri-operative complications, which include duration of operation, intra-operative blood loss, recurrent nerve (RLN) injury and hypocalcaemia in both groups.

Hypothesis: Patients who undergoing thyroidectomy without neck extension will have less post-operative pain and there are no significant difference of post-operation complications between both groups.

Detailed Description

Conventional open thyroid surgery is still one of the most common operations performed globally. Traditionally, patients who undergoing thyroid surgeries are usually positioned with extended neck by using pillow under shoulder in order to facilitate neck exposure and make the surgery easier. However, the degree of benefit from the extended neck is doubtful and there is little objective evidence that suggest extended neck thyroid surgery offers better outcomes. On the the hand, over-extension of the neck should be avoided because of it is associated with post-operative pain, vomiting, spinal damage and stroke. The objective of the present study is to compare the post-operative pain in patients with neck extension and without neck extension. In addition to that, we also like to determine the benefit of neck exposure and peri-operative complications, which include duration of operation, intra-operative blood loss, recurrent nerve (RLN) injury and hypocalcaemia in both groups. This is a prospective randomized controlled trial, which will be conducted from 1st of March 2012 till 30th September 2012. Given that approximately 300 to 400 patients would undergo thyroid surgery in each year, we estimated 180 patients will be recruited and randomly divided into 2 groups (neck extension and no neck extension) before undergoing open thyroid surgery for this trial. Visual analogue scale (VAS) is used to determine the post-operative pain. Primary end point and other peri-operative variables are then analyzed with SPSS software.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
180
Inclusion Criteria
  • All patients who will be undergoing thyroid surgery in Queen Mary Hospital and Tung Wah Hospital.
  • Age from 18 till 80 years old.
Exclusion Criteria
  • Patients with history of bleeding disorder and tendency.
  • Patients with history of cervical spine surgery and disease.
  • Patients with history of RLN injury and underlying cause of hypocalcemia.
  • Patient with mental disorder and subnormal intelligence.
  • Pregnant and lactating women.
  • Patients who is having other surgical problem that needed other surgical procedure performed at the same setting.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Extended neckExtended neck with standard support or pillowPatients who undergoing thyroid surgeries are positioned with extended neck by using pillow under shoulder in order to facilitate neck exposure and make the surgery easier.
Primary Outcome Measures
NameTimeMethod
Post-operative pain scoreFirst postoperative week

Post-operative pain ranges from 0 to 10 according to the Visual Analogue pain scale (VAS), and which 0 is 'No pain' and 10 is 'Worst possible pain'

Secondary Outcome Measures
NameTimeMethod
Surgically related complicationsImmediate and after 6 months

Neck exposure, duration of operation, skin incision length, intra-operative blood loss, RLN injury, post-operative hypocalcaemia

Postoperative pain scoresDay 0, day 1 and after two weeks

Post-operative pain ranges from 0 to 10 according to the Visual Analogue pain scale (VAS), and which 0 is 'No pain' and 10 is 'Worst possible pain'

Trial Locations

Locations (2)

Tung Wah Hospital

🇭🇰

Sheung Wan, Hong Kong

Queen Mary Hospital

🇭🇰

Hong Kong, Hong Kong

© Copyright 2025. All Rights Reserved by MedPath