Trial reportBMC anesthesiology2025
Neck extension during thyroidectomy: effects on early postoperative cognitive function and optic nerve sheath diameter- a randomized controlled trial.
Trial report in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07407972 (Effect of Optıc Nerve Dıameter ın Tymphanoplasty Surgery Performed ın Lateral Head Posıtıon Under General Anesthesia), which is not on this map. Not yet cited in PubMed.
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Effect of Optıc Nerve Dıameter ın Tymphanoplasty Surgery Performed ın Lateral Head Posıtıon Under General Anesthesia
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5 authors.
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Abstract
backgroundDuring thyroidectomy, patients are commonly positioned with neck extension using a shoulder roll. Excessive extension may impair arterial and venous outflow, compromise cerebral perfusion, and elevate intracranial pressure, potentially leading to postoperative cognitive impairment. This study investigated the effect of shoulder-roll-assisted neck extension on cognitive outcomes and on optic nerve sheath diameter (ONSD).
methodsAfter tracheal intubation, patients were randomly assigned to either a shoulder roll group or a control group without a roll. The primary outcome was the Montreal Cognitive Assessment (MoCA) score at 6 h postoperatively. Secondary outcomes included ONSD and the degree of neck extension.
resultsPostoperative MoCA scores were significantly lower in the shoulder roll group (20.56 ± 2.71) compared with the control group (23.57 ± 2.37; P < 0.001). ONSD increased over time in both groups (P < 0.001), but repeated-measures analysis showed no significant difference between groups (P = 0.333). Neck extension was greater in the shoulder roll group (126 ± 4.36°) than in the control group (116 ± 3.74°; P < 0.001).
conclusionsShoulder roll positioning during thyroidectomy was associated with lower MoCA scores at 6 h, indicating mild postoperative cognitive decline. Although greater neck extension was observed, ONSD values did not significantly differ between groups.
trial registrationMuğla Sıtkı Koçman University Clinical Research Ethics Committee (approval number T-XII, June 17, 2019). Australian New Zealand Clinical Trials Registry (registration number: ACTRN12619001066178, date of registration: July 31, 2019).
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