Correlation between surgical position and neck pain after thyroidectomy: a prospective observational study

Abstract Objective : to determine the correlation between the degree of neck hyperextension on the operative table and the postoperative pain in patients undergoing open thyroidectomy. Background : thyroid diseases are one of the most common health problems worldwide. Although they represent a necessary step in order to perform thyroidectomy, hyperextension of the neck can potentially increase post-operative pain. Study design and methods : following the STROBE guidelines for observational studies, patients were prospectively enrolled from the cohort of patients operated at the Endocrine Surgery Unit of the University Hospital of XX, between May and July 2021. Both of patients who underwent total thyroidectomy or hemi-thyroidectomy were recruited. The following data were analysed in order to find a correlation with post-operative pain at 24 hours: age, gender, type of surgery, BMI, operative time, degree of neck extension. Results : overall, 195 patients were enrolled. A direct, statistically significant correlation emerged between the degree of neck hyperextension and the postoperative pain 24 hours after surgery, regardless of the pain of the surgical wound (p< 0.001; Beta 0.270). Conclusions : a direct correlation emerges between neck tilt angle and postoperative neck pain. Moreover, total thyroidectomy (TT) predisposes more to post-operative neck pain, considering the type of surgery. Implications for research, policy, and practice: as the neck angle increases on the surgical bed, postoperative pain may increase.