Abstract
ObjectiveTo investigate the effectiveness of high-concentration oxygen on the improvement of throat symptoms and voice changes after thyroid surgery and its protection of the parathyroid function.MethodsA total of 600 patients undergoing thyroid surgery who met the inclusion criteria were randomly divided into the experimental group (n = 300) and the control group (n = 300) by using a random number generator. The patients in the experimental group underwent high-oxygen treatment [FiO280 (8 L/min)] for 6 continuous hours after returning to the ward after surgery. The patients in the control group underwent low-oxygen treatment [FiO230 (2 L/min)] for 6 continuous hours after returning to the ward after surgery.ResultsThe postoperative incision pain score of patients in the experimental group was significantly better than that in the control group at 6 h (1.07 ± 0.80 VS 1.23 ± 0.95, P=0.031) and 12 h (1.08 ± 0.64 VS 1.20 ± 0.73, P=0.041). The postoperative throat pain score of the patients in the experimental group was significantly better than that of the control group at 6 h (1.40 ± 0.85 VS 1.59 ± 0.97, P=0.011) and 12 h (1.40 ± 0.85 VS 1.59 ± 0.97, P=0.019). The PONV score of the patients in the experimental group was significantly better than that of the control group at 12 h (0.09 ± 0.19 VS 0.14 ± 0.37, P=0.024). The Voice Handicap Index score of the patients in the experimental group was significantly better than that of the control group at 24 h (2.89 ± 5.92 VS 4.10 ± 6.31, P=0.017), 36 h (2.46 ± 5.06 VS 3.43 ± 5.97, P=0.035), and 48 h (2.46 ± 5.06 VS 3.43 ± 5.97, P=0.032).ConclusionHigh-concentration oxygen can alleviate PONV and pain after thyroid surgery, with less severe voice changes potentially. However, its effects on swallowing function, and parathyroid function need to be further verified.Clinical Trial Registration NumberChiCTR-IOR-17012765 (China Clinical Trial Registry clinical trial registration center [http://www.chictr.org.cn/index.aspx)
Highlights
In recent years, the number of patients with thyroid cancer has exploded, making it the solid malignant tumor with the fastestgrowing incidence [1]
The application of high-concentration oxygen in abdominal surgery, obstetric-gynecologic surgery, and tonsil surgery can significantly reduce the incidence of postoperative nausea and vomiting (PONV), and some randomized controlled studies on the protective effect of sufficient high-concentration oxygen during the perioperative period show that inhalation of high-concentration oxygen can effectively reduce the incidence of incision infection after surgery [11,12,13,14,15,16,17]
Based on the above principles, it is conceivable that in thyroid surgery, high-concentration oxygen can reduce inflammatory and immune responses, reduce edema at the surgical site and around the trachea, improve the resistance of the recurrent laryngeal nerve and the superior laryngeal nerve to injury, and improve blood supply and oxygen supply to the parathyroid gland to thereby improve PONV, pain, voice change, and numbness of the hands, feet, and perioral area caused by impaired parathyroid function
Summary
The number of patients with thyroid cancer has exploded, making it the solid malignant tumor with the fastestgrowing incidence [1]. In view of the large increase in the number of patients in recent years, thyroid surgery has become one of the most common surgical procedures. A variety of throat symptoms, such as postoperative nausea and vomiting (PONV), pain and difficulty swallowing, can appear after surgery. Their incidence is reported to be 20-30% to 70-80% [3, 4]. It is reported that the incidence rate of temporary hypoparathyroidism is 14-60% after thyroidectomy [2] These symptoms may lead to delays in the patient’s postoperative recovery [10]
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