Cormack-lehane score and dexamethasone as predictors of hoarseness after bronchocath extubation

Abstract EN

Objective : to assess the role of intraoperative laryngoscopic Cormack-Lehane score and preventive Dexamethasone in predicting the frequency of hoarseness post-Bronchocath extubation. Methods : this is a retrospective review of review of 105 subjects, of both genders, aged 15-85 years who were booked for video-assisted thoracoscopic surgical procedures for different causes, under general balanced bronchocath anesthesia at King Hussein Hospital, King Hussein Medical Centre, Amman-Jordan, during the period Janurary 2010 to March 2011.

Preoperatively, patients were allocated into two groups.

Group I (n = 52) received intravenous 16mg of Dexamethasone and group II (n = 53) received intravenous 8mg of Dexamethasone.

General anesthesia was induced and modified Cormack-Lehane laryngoscopic scoring system (mCMLS) (I, IIA, IIB, III and IV) was used to divide each group into two subgroups.

Group Ia included 49 patients with mCMLS I, IIA, IIB and group Ib included three patients with mCMLS III, IV.

Group IIa included 50 patients with mCMLS I, IIA, IIB and group IIb included three patients with mCMLS III, IV.

Bronchcath was inserted in all patients.

Post-tracheal extubation frequency of hoarseness at two, and 30 hour intervals was recorded in all groups.

The significance level of the study was set at < 0.05. Results : the frequency of hoarseness post-tracheal extubation at two hour intervals was significantly more in group IIa than in group Ia (10 % and 2.04 %, respectively < 0.05).

The frequency of hoarseness post bronchocath extubation was less in group Ib than in group IIb (33.3 % and 66.7 % respectively, although not significantly > 0.05). Conclusion : single preoperative administration of 16 mg Dexamethasone among patients with laryngoscopic Cormack-Lehane score I, IIa and IIb are good predictors of low frequency of hoarseness post bronchocath extubation in subjects scheduled for video assisted thoracoscopic surgery.