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Is Postoperative Orotracheal Intubation Necessary in Patients Who Underwent Transoral Robotic Surgery due to Obstructive Sleep Apnea Syndrome?

1.

Department of Anesthesiology and Reanimation, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Türkiye

2.

Department of ENT, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Türkiye

Arch Health Sci Res 2023; 10: 237-241
DOI: 10.5152/ArcHealthSciRes.2023.23127
Read: 433 Downloads: 270 Published: 17 October 2023

Objective: In this study we investigated whether postoperative changing nasotracheal to orotracheal intubation is necessary after trans-oral robotic surgery (TORS) for obstructive sleep apnea syndrome (OSAS).

Methods: A total of 151 patients who underwent TORS between 2011 and 2023 with the diagnosis of OSAS were included. All patients were transferred to post anaesthesia intensive care unit (PACU) after operation with orotracheal (group O: 73 patients, operated between 2011 and 2017) or nasotracheal tubes (group N: 78 patients, operated between 2017 and 2023). Age, gender, American Society of Anesthesiologists scores, Mallampati scores, PACU stay, pH in arterial blood gas samples taken during this period (1—"rst hospitalization, 2—12 hours later, 3—before extubation), PCO2, PO2, Base excess (BE), lactate values, total amount of #uid administered, presence of complications, and discharge times were collected from the patients "les. Statistical analyses were done between the groups.

Results: There was no statistical di$erence between groups regarding patient’s demographic data. The distribution of Mallampati scores of the patients was 52% in group O and 55% in group N (P=.97). Complication rate was 16% in group O (6 bleeding, 4 vomiting, 1 need for reintubation) and 19% in group N (6 bleeding, 7 vomiting, 2 need for reintubation). The length of stay in the PACU in both groups was 24.9 hours (P=.92). The amount of #uids given in PACU was not statistically di$erent (P=.14). The length of hospital stay was the same in both groups (7 days). No statistical di$erence was observed between the 2 groups in any measurement period of arterial blood gas values, pH, PO2, PCO2, BE, and lactate.

Conclusion: Our results support that nasotracheal intubation itself is safe both during surgery and postoperative period in OSAS patients who underwent TORS, and there is no need to change it to orotracheal intubation at the end of the operation. We believe that our study will contribute to the management of the early postoperative process in this patient group.

Cite this article as: Saygı Emir N, Karaman Koç A. Is postoperative orotracheal intubation necessary in patients who underwent transoral robotic surgery due to obstructive sleep apnea syndrome? Arch Health Sci Res. 2023;10(3):237-241.

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