Ultrasonographic evaluation of the postoperative airway edema after robotic prostatectomy: a single center observational study.

OBJECTIVE: During general anesthesia, different parts of the upper airway can change for various reasons, such as intravenous fluids, airway trauma due to airway devices used, stasis in tissues due to position, reactions to medications used, etc. For many reasons, edema in the airway or the surrounding tissue can narrow the airway. This study compares preoperative and postoperative ultrasound measurements of upper airway anatomy in patients with robotic radical prostatectomy in the Trendelenburg position.

PATIENTS AND METHODS: This study was conducted at the Health Sciences University Ankara City Hospital between May and December 2022. The preoperative and postoperative measurements of tongue thickness, midsagittal tongue cross-sectional area, tongue width, lateral pharyngeal wall thickness, parapharyngeal region thickness, and submental region thickness were analyzed and compared.

RESULTS: There was a difference between the preoperative and postoperative median sagittal tongue cross-sectional area, tongue volume values, LPW values, parapharyngeal region thickness, and neck circumference values. We found that the thickness of the submental region and the thickness of the parapharyngeal region increased as the amount of fluid administered intraoperatively increased.

CONCLUSIONS: Upper airway edema is the most challenging problem for anesthetists during extubation due to position and pneumoperitoneum. Restrictive fluid management may have beneficial effects in preventing clinically important airway edema.