Comparison Of Analgesic Efficacy Of Bilateral Superficial Cervical Plexus Block With 0.5% Ropivacaine Alone Versus 0.5%Ropivacaine With Dexmedetomidine In Thyroid Surgeries Under General Anaesthesia: A Prospective Randomized Double Blinded Study (original) (raw)
Related papers
British Journal of Anaesthesia, 2007
Background. The use of regional anaesthesia in thyroid surgery remains controversial. This double-blind, randomized controlled study was conducted to evaluate the analgesic efficacy of bilateral superficial cervical plexus block (BSCPB) performed under general anaesthesia in patients undergoing total thyroidectomy. Methods. Eighty-seven consecutive consenting patients were randomized to receive a BSCPB with saline (Group P, n¼29), ropivacaine 0.487% (Group R, n¼29), or ropivacaine 0.487% plus clonidine 5 mg ml 21 (Group RC, n¼29). Sufentanil was given during the intraoperative period for a 20% increase in arterial mean pressure or heart rate in a patient with a bispectral index between 40 and 60. All patients received 4 g of acetaminophen during the first 24 h after operation. The pain score was checked every 4 h and nefopam was given for pain score .4 on a numeric pain scale. Results. During surgery, the median sufentanil requirements were significantly reduced in Group RC compared with Groups R and P (0.32 vs 0.47 and 0.62 mg kg 21 ; P,0.0001). After surgery, the number of patients requiring nefopam within 24 h of surgery was significantly lower in Groups R and RC than in Group P (16 and 19 vs 25; P¼0.03). At post-anaesthetic care unit admission, median (range) pain scores were significantly lower in Groups R [3 (0-10)] and RC [3 (0-8)] than in Group P [5 (0-8), P¼0.03]. No major complications of BSCPB occurred during study. Conclusions. BSCPB with ropivacaine and clonidine improved intraoperative analgesia. BSCPB with ropivacaine or ropivaciane and clonidine was effective in reducing analgesic requirements after thyroid surgery.
Brazilian Journal of Anesthesiology (English Edition), 2019
Introduction: Bilateral superficial cervical plexus block (BSCPB) is a common method used for analgesia in thyroid surgery. We investigated the analgesic efficacy of bilateral superficial cervical plexus block in the intraoperative and postoperative periods. Materials and methods: Patients (n = 46) undergoing thyroidectomy were randomly separated into the following 2 groups: the general anesthesia group (GA; n = 23) and the general anesthesia plus BSCPB group (GS; n = 23). The intraoperative analgesic requirement (remifentanil) and visual analog scale (VAS) score at multiple time points during the postoperative period (after extubation, at 15, 30 minutes and 1, 2, 6, 12, 24, and 48 hours post operation) were evaluated. Total tramadol and paracetamol consumption as well as the amount of ondansetron used was recorded. Results: The intraoperative remifentanil requirement was significantly lower in the GS Group than in the GA Group (p = 0.009). The postoperative pain scores were significantly lower in the GS Group than in the GA Group at 15 (p < 0.01), 30 (p < 0.01) minutes, and 1 (p < 0.01), 2 (p < 0.01), 6 (p < 0.01), 12 (p < 0.01) and 24 (p = 0.03) hours. The postoperative tramadol requirement was significantly lower in the GS Group than in the GA Group (p = 0.01). The number of patients that used ondansetron was significantly lower in the GS Group than in the GA Group (p = 0.004). Conclusion: We concluded that BSCPB with 0.25% bupivacaine reduces the postoperative pain intensity and opioid dependency in thyroid surgery patients.
Anesthesiology and Pain Medicine, 2021
Context: Thyroid surgeries done under general anaesthesia use intravenous (iv) drugs as analgesics. A simple superficial cervical plexus block can reduce dose of iv analgesics and provide excellent analgesia. This study evaluated the analgesic efficacy of ultrasound guided Bilateral Superficial Cervical Plexus Block (BSCPB) in thyroidectomies and its opioid sparing effect. Aim: Evaluation of analgesic efficacy of BSCPB and its opioid sparing effect in thyroidectomies. Settings and Design: Routine data based observational study conducted during March 2017 to January 2018 in a tertiary cancer institute in South India. Materials and Methods: The study involved fifty adult ASA I and II patients who received BSCPB with 0.5% ropivacaine 10 ml for thyroidectomies along with general anaesthesia and fifty patients without BSCPB from routine database. Postoperative pain scores for 24 hours were compared and reduction in opioid requirement in BSCPB group was analysed. Statistical analysis: Statistical analysis was done using Statistical package for social sciences package 11 software (SPSS Inc, Chicago). Quantitative data was analysed with Student's t test and categorical data with chi-square test. Friedman two-way ANOVA was used to test significance of pain at different times in BSCPB group. Mann Whitney U test was used to compare pain score between the two groups. Results: There was statistically significant reduction in postoperative pain in the BSCPB group (p=0.0001). The total opioid requirement showed a statistically significant reduction in the BSCPB group (mean ± SD 2.6 ± 2 vs. 6.6 ± 1). Conclusion: BSCPB provides excellent analgesia with a reduction in opioid consumption following thyroidectomies.
International Journal of Medical Sciences, 2000
Purpose: This study was designed to compare the effect on postoperative pain, opioid consumption and the length of stay in postoperative care unit (PACU) after three different intraoperative analgesic regimens in thyroid surgery. Methods: Seventy five patients were enrolled into the study and assigned to one of three groups, fentanyl, sufentanil or remifentanil (n=25 for each group). Before the end of surgery, paracetamol 1 gr and nefopam 20 mg was also administered in all patients. Pain scores, opioid demand and the length of stay in PACU were assessed in a blind manner. Results: Post operative pain scores were significantly lower in the fentanyl and sufentanil groups compared to remifentanil group (55 ± 15, and 60 ± 10 versus 78± 12, P < 0.05). Patients in the remifentanil group stayed longer in the PACU 108± 37 min versus 78±31 and 73 ± 25 min, (P< 0.05). Conclusion: After remifentanil based analgesia, anticipation of postoperative pain with opioid analgesic appears mandatory even for surgery rated as being moderately painful, otherwise longer opioid titration due to higher pain scores might delay discharge time.
SOJ Anesthesiology & Pain Management
Background: Thyroidectomy is associated with mild to moderate type of pain. The employment of regional anesthesia for thyroid surgery remains controversial for some studies. We tested the hypothesis that multiple injection of Bilateral Superficial Cervical Plexus Block (BSCPB) reduced pain scores, opioid consumption and prolongs time of analgesic request after thyroid surgery. Methods: of 45 patients, 40 completed the study. They were allocated in to two groups: the Bilaterela Superficial Cervical Plexus Block (BSCPB) and the control group. The outcome measures were the severity of pain measured on Visual Analogue pain rating Scale (VAS), total opioid consumption, and first analgesic request time during the first postoperative 24 hours. Results: The main outcomes recorded during the first 24 hours were Visual Analogue scale pain score (VAS, 0-10), total opioid consumption and the first analgesic request time. There were VAS scores at rest with median (IQR) in mm 9.00(5.00-16.00) vs. 15.00(10.00-22.00), p < 0.013 and at swallowing with mean ± SD in mm 11.00 ± 8.52 vs 28.70 ± 7.40 p < 0.001for the BSCPB and control group after 24 hours of surgery respectively. It was also showed a statistically significant (p < 0.005) difference observations between the groups throughout the whole period of visit. Twenty four hours after surgery, total tramadol consumption was significantly reduced in cases (BSCPB) and control groups as 550 vs 2350 milligram p < 0.05, respectively. After surgery, time for first analgesic request was significantly prolonged in BSCPB (560.00 vs 26.00, p < 0.001) minutes. Conclusion and recommendation: A multiple injection of BSCPB provided superior analgesia for elective thyroid surgery done under general anaesthesia. We recommend BSCPB to be included as part of multimodal analgesia before intubation for thyroidectomy.
Saudi Journal of Anaesthesia, 2018
Purpose: Thyroidectomy causes postoperative pain and patient discomfort. Bilateral superficial cervical plexus block is a regional anesthesia technique that can provide analgesia during and after surgery. This study aims to compare the effectiveness of ultrasound (US)-guided versus landmark (LM) technique for bilateral superficial cervical plexus block in thyroidectomy. Patients and methods: Thirty-six patients undergoing thyroidectomy were divided into two groups randomly (n=18); either US-guided (US group) or LM technique (LM group) for bilateral superficial cervical plexus block. Patient-controlled analgesia was used to control postoperative pain. Intraoperative opioid rescue, postoperative visual analog scale (VAS) score and opioid consumption were measured. Results: The number of patients who required intraoperative opioid rescue was significantly lower in the US group (p≤0.05). There was no significant difference in postoperative VAS score at 3 hours (p>0.05), but postoperative VAS score at 6 and 24 hours was significantly lower in the US group (p≤0.05). Twenty-four hour postoperative opioid consumption was significantly lower in the US group (p≤0.05). Conclusion: Ultrasound-guided bilateral superficial cervical plexus block is more effective in reducing pain both intra-and postoperatively compared with landmark technique in patients undergoing thyroidectomy.
European Archives of Oto-Rhino-Laryngology, 2018
Background and objective We conducted a prospective double-blind randomized study assessing bupivacaine end-of-surgery wound infiltration for pain relief in thyroid surgery. Methods Patients were randomly divided into two groups: Group S, local wound infiltration with saline solution; Group B, bupivacaine 0.5% was administered. Pain perception was measured using visual analogue scale (VAS) during post-anaesthetic care unit (PACU) stay every 10 min and during the 24 postoperative hours admission at 2, 4, 6, 12, and 24 h after surgery. The total consumption of analgesics (morphine and nefopam) was recorded. Results Sixty patients were studied. The VAS scores were significantly lower in the bupivacaine administered group in the post-anaesthetic care unit (PACU) at 0, 10, 20, 30, 40, 50 and 60 min, and during the hospital stay at hours 6, 12, 18 and 24. The number of patients who required postoperative opioid rescue was significantly lower in group B. No patient in group B developed neurological or cardiological complications after infiltration. Conclusion Bupivacaine application is effective in decreasing postoperative pain and analgesic requirement during the hospital stay for patients with thyroidectomy.
Anesthesiology Research and Practice, 2018
Introduction. The pain after thyroid surgery is considered of moderate intensity and short duration. Most trials showed significant reduction in pain intensity and severity of pain in patients for whom bilateral superficial cervical plexus block (BSCPB) was done. Objective. To assess the postoperative analgesic effect of BSCPB for thyroid surgery. Methods. Sixty six euthyroid patients were recruited and assigned to two groups (33 patients each). Group 1 BSCPB and Group 2 standard analgesia. The unpaired Student’s t-test and Mann–Whitney test were used for comparison. Statistical significance was stated at p value < 0.05. Results. The median postoperative pain score (NRS) was 3 in the BSCPB group and 5 in the control group (p=0.002). There was also statistically significant difference at 6th, 12th, and 24th hour showing a lower median pain score in the BSCPB group compared to the control group. The median time was (360 minutes) in the treatment group and (180 minutes) in the contr...
Sri Lankan Journal of Anaesthesiology
Background: Post-operative pain for thyroid surgeries under general anaesthesia is inadequately managed. Bilateral superficial cervical plexus block (BSCPB) for thyroid surgery causes adequate analgesia without any significant side effects. Dexamethasone is commonly used in anaesthesia to prevent postoperative nausea and vomiting (PONV). The study objective was comparison of efficacy between add-on Dexamethasone intravenously and Ropivacaine alone in bilateral superficial cervical plexus block versus Dexamethasone added with Ropivacaine in the same block in producing postoperative analgesia and in preventing post-operative nausea vomiting. Methods: Randomized single-blind clinical study was done on eighty patients of 18-60 years of either sex, ASA I and II, scheduled for elective thyroid surgery under general anaesthesia. Patients were divided into two groups (n=40). In bilateral superficial cervical plexus block, Group DB (n=40) had received 20 ml Inj. Ropivacaine (0.25%) and 2ml (...