The effect of bed head slope on patients’ outcomes in early postoperative period after thyroidectomy : A randomized controlled trial.

Abstract

THE EFFECT OF BED HEAD SLOPE ON PATIENTS’ OUTCOMES IN EARLY POSTOPERATIVE PERIOD AFTER THYROIDECTOMY: A RANDOMIZED CONTROLLED TRIAL Serpil Yüksel* , Seher Deniz Öztekin, Zeynep Temiz, Gülay Altun Uğraş, Emel Şengül, Serkan Teksöz, Nihal Sunal, İlhan Öztekin, Ertuğrul Göksoy Background: The appropriate position that will be given to patient is important to prevent hematoma related pulmonary complications and provide comfort in early postoperative period of thyroidectomy patients (1,2). Aim: This study was carried out to determine the effects of bed head slope on patients’ outcomes in early postoperative period after thyroidectomy. Methodology: The sample of this randomized controlled trial included 114 thyroidectomy patients in a university hospital from May 2013 to September 2013. By randomization, the patients were divided into three groups including 38 patients in each. Their bed head slopes were provided in three levels (0° flat, 30° low-fowler and 45° high fowler positions). In early postoperative period of thyroidectomy, outcomes of patients were evaluated at 1st, 2nd, 3rd, and 4th hours. Data were analyzed using number, percentage, mean, standard deviation, Pearson’s chi-square, Kruskal Wallis, Friedman and advanced analysis tests. Results: The mean age of patients was 46.61±15.28. The majority of the patients were female (83.3%) and 84.2% had underwent total thyroidectomy. There was statistical significance among the three groups for patients’ amount of drainage at 1st, 3rd, and 4th hours after thyroidectomy. However, amount of drainage of patients in flat group was significantly higher compared to high fowler group at 2nd hour. No hematoma was seen in any of the patients. Dyspnea did not occur in any of the patients in low fowler group. The majority of patients with breathing failure had bed head levels of “0” degree in 2nd and 3rd hours after thyroidectomy. Conclusion: The findings of this study showed that affected breathing and amount of drainage of thyroidectomy patients of different positions during early postoperative period. Implications of perioperative nursing: Flat, low fowler and high fowler positions were safe and, low fowler position was more comfortable for the thyroidectomy patients in early postoperative period. Key Words: Bed head slope, Nursing care, Postoperative period, Position, Thyroidectomy Reference 1 Terris DJ, Snyder S, Carneiro-Pla D, Inabnet WB 3rd, Kandil E, Orloff L, Shindo M, Tufano RP, Tuttle RM, Urken M, Yeh MW, American Thyroid Association Surgical Affairs Committee Writing Task Force. American Thyroid Association Statement on outpatient thyroidectomy. Thyroid, 2013; 23: 1193-202. 2 Rosato L, De Crea C, Bellantone R, Brandi ML, De Toma G, Filetti S, Miccoli P, Pacini F, Pelizzo MR, Pontecorvi A, Avenia N, De Pasquale L, Chiofalo MG, Gurrado A, Innaro N, La Valle G, Lombardi CP, Marini PL, Mondini G, Mullineris B, Pezzullo L, Raffaelli M, Testini M, De Palma M. Diagnostic, therapeutic and health-care management protocol in thyroid surgery: a position statement of theItalian Association of Endocrine Surgery Units (U.E.C. CLUB). J Endocrinol Invest, 2016, Apr 8. *Presenter author: Assistant Professor Serpil Yüksel, Ph.D, R.N Konya Necmettin Erbakan University, Faculty of Health Science, Division of Nursing, Department of Surgical Nursing, Konya, Turkey. *Contact Author: Serpil Yüksel Affiliation: Konya Necmettin Erbakan University, Faculty of Health Science, Division of Nursing, Department of Surgical Nursing, Konya, Turkey. Postal address: Necmettin Erbakan Üniversitesi, Sağlık Bilimleri Fakültesi, Cerrahi Hastalıkları Hemşireliği Anabilim Dalı, İhsaniye Mah. Kazım Karabekir Cad. 42040. Selçuklu/Konya, Turkey. Office phone: +90-(0)332 3204049 (2029 ext.), Office fax: +90-(0)332-3204059 E-mail: yukselserpil1977@gmail.com