In the immediate postoperative period, the contributions of anesthetists to reduce the risk of hematoma formation after neck surgery include adequate control of arterial pressure and pain and aggressive prevention and treatment of nausea and vomiting. These objectives must have been met and unrestricted upper airway patency assured before discharge of these patients from the postanesthesia care unit to the normal ward.
Regular postoperative measurements of the neck circumference at a defined location may be helpful for early detection of hematoma formation and planning of further management. Clinical signs of respiratory distress are generally considered as late manifestations of rebleedings. Drainage systems may not necessarily allow early detection of rebleeding because they do not reliably evacuate accumulated blood. Even discrete bleeding into deep neck structures without apparent neck swelling may cause severe laryngeal edema formation (16).
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