The Effects of Different Degrees of Head-of-bed Elevation

Thyroidectomy is a safe surgical procedure commonly used for the treatment of benign or malignant tumors, multinodular goiter and Graves disease. However, because of the rich vascular structure of the thyroid gland, serious complications including hemorrhage, hematoma and hematoma-related dyspnea can develop after thyroidectomy. The American Thyroid Association also suggested to keep the patient in a head-up at 45°-Fowler's position in the post anesthesia care unit following thyroidectomy to prevent hematoma formation on the incision site by facilitating venous return from the head and neck. The mentioned guideline does not offer any recommendations regarding the position that should be given to the patients at surgical clinic after thyroidectomy. Therefore, this study aimed to identify the effects of different degrees of head-of-bed elevation on respiratory pattern including respiratory rate, peripheral oxygen saturation and dyspnea, and drainage including amount of drainage and hematoma formation.

Inclusion criteria

The eligible participants were those

• who were not using anticoagulants,
• whose coagulation tests were normal,
• who had hemovac drains inserted during thyroidectomy,
• who had no contraindication to positioning (e.g., heart failure, chronic obstructive pulmonary disease, dyspnea before surgery and respiratory complications in the post-anesthesia care unit),
• who could tolerate positioning, and who volunteered to participate and signed the informed consent form

Exclusion criteria

The participants excluded from the study;

• who were using anticoagulants,
• whose coagulation tests were abnormal,
• who had hemovac drains inserted during thyroidectomy,
• hemovac drains removed in the post-anesthesia care unit following thyroidectomy,
• who did not tolerate positioning and who refused to participate