Background Parathyroidectomy has been proposed as a method for reducing parathyroid hormone levels. We evaluated the effects of ultrasound-guided bilateral superficial cervical plexus block (BSCPB) on the quality of recovery of uremia patients with secondary hyperparathyroidism (SHPT) following parathyroidectomy. Methods Eighty-two uremia patients who underwent parathyroidectomy and exhibited SHPT were randomly allocated to the BSCPB group or the control group (CON group). The patients received ultrasound-guided BSCPB with 7.5 ml of ropivacaine 0.5% on each side (BSCPB group) or equal amount of 0.9% normal saline (CON group). The primary outcome of the Quality of Recovery-40(QoR-40) score was recorded on the day before surgery and postoperative day 1(POD1). Secondary outcomes including total consumption of remifentanil, time to first required rescue analgesia, number of patients requiring rescue analgesia, and total consumption of tramadol during the first 24 h after surgery were recorded. The occurrence of postoperative nausea or vomiting (PONV) and the visual analogue scale (VAS) scores were assessed and recorded. Results The scores on the pain and emotional state dimensions of the QoR-40 and the total QoR-40 score were higher in the BSCPB group than in the CON group on POD1 (P = 0.000). Compared with the CON group, the total consumption of remifentanil was significantly decreased in the BSCPB group (P = 0.000). The BSCPB group exhibited longer time to first required rescue analgesia (P = 0.018), fewer patients requiring rescue analgesia (P = 0.000), and lower postoperative total consumption of tramadol during the first 24 h after surgery (P = 0.000) than the CON group. The incidence of PONV was significantly lower in the BSCPB group than in the CON group (P = 0.013). The VAS scores in the BSCPB group were lower than those in the CON group at all time-points after surgery (P = 0.000). Conclusion Ultrasound-guided BSCPB with ropivacaine 0.5% can enhance the quality of recovery, postoperative analgesia, and reduce the incidence of PONV in uremia patients with SHPT following parathyroidectomy. Trial registration ChiCTR1900027185 . (Prospective registered). Initial registration date was 04/11/2019.

Introduction Surgical management is commonly used for thyroid cancer. We evaluated the effects of systemic lidocaine versus dexmedetomidine on the recovery quality and analgesia after thyroid cancer surgery. Methods A total of 120 patients with thyroid cancer were randomly allocated to group L (received lidocaine 1.5 mg/kg loading, continuously infused 1.5 mg/kg per hour), group D (received dexmedetomidine 0.5 µg/kg loading, continuously infused 0.5 µg/kg per hour) and group C (received normal saline), with 40 cases in each group. Anaesthesia induction and maintenance were performed using target-controlled infusions (TCIs) of propofol and remifentanil. The primary outcome of the quality of recovery-15 (QoR-15) score was recorded on the day before surgery and postoperative day 1 (POD1). Secondary outcomes included the consumption of remifentanil during surgery, time to first required rescue analgesia, number of patients requiring rescue analgesia, postoperative cumulative consumption of tramadol, visual analogue scale (VAS) pain score, incidence of postoperative nausea or vomiting (PONV) and side effects. Results The total score of the QoR-15 at POD1 (median, IQR) was higher in group L (128.0, 122.0–132.8) and group D (127.5, 122.5–132.5) compared to group C (118.5, 113.0–123.5) ( P = 0.000). Compared to group C, systemic lidocaine and dexmedetomidine reduced cumulative consumption of remifentanil and VAS pain score ( P = 0.000). The time to first required rescue analgesia (mean, SD) was longer in group L (8.1 h, 1.2 h) and group D (8.5 h, 1.9 h) than group C (5.9 h, 0.9 h) ( P = 0.000). The number of patients requiring rescue analgesia was lower in group L (8/40, 20%) and group D (6/40, 15%) than group C (16/40, 40%) ( P = 0.029), and cumulative consumption of tramadol (mean, SD) was lower in group L (44.0 mg, 17.1 mg) and group D (51.7 mg, 14.1 mg) than group C (73.9 mg, 18.4 mg) ( P = 0.000). The incidence of PONV in group L (7/40, 17.5%) and group D (9/40, 22.5%) was lower than group C (18/40, 45.0%) ( P = 0.016). Bradycardia (heart rate  less than 50 beats/min or lower) was noted in 25 patients (25/40, 62.5%), which was reversed by intravenous administration of atropine 0.5 mg. Conclusion Systemic lidocaine and dexmedetomidine had similar effects on enhancing the quality of recovery, alleviating the intensity of pain and reducing the incidence of PONV after thyroid cancer surgery. However, dexmedetomidine may result in bradycardia. Therefore, lidocaine was superior to dexmedetomidine. Trial registration ChiCTR.org.cn (ChiCTR2000038442). Registered on September 22, 2020.

Background:Parathyroidectomy has been proposed as method for reduction of PTH levels. We evaluated the effects of ultrasound-guided BSCPB on the quality of recovery following parathyroidectomy with secondary hyperparathyroidism.Methods:Eighty-two patients undergoing parathyroidectomy with secondary hyperparathyroidism were randomly allocated to BSCPB group (ultrasound-guided BSCPB with 7.5ml of ropivacaine 0.5% on each side) and the CON group(normal saline).The primary outcome of QoR-40 score was recorded.Secondary outcomes including total consumption of propofol and remifentanil,the numbers of patient requiring rescue analgesia, the time to first require rescue analgesia, the incidence of PONV, and the VAS scores were recorded.Results:The score in the pain and emotional state dimensions of QoR-40,and total QoR-40 score were higher in the BSCPB group than the CON group on POD1(P=0.000).Compared with the CON group,the total consumption of propofol and remifentanil was significantly decreased in the BSCPB group (P=0.000).Compared with the CON group, the time to first require rescue analgesia was longer(P=0.018),and numbers of patient requiring rescue analgesia were decreased in the BSCPB group ( P=0.000).The incidence of PONV was significantly lower in the BSCPB group than the CON group (P<0.05).The VAS scores in the BSCPB group were lower than the CON group in any time point after surgery (P=0.000). Conclusion: Ultrasound-guided BSCPB with ropivacaine 0.5% can enhance the quality of recovery, postoperative analgesia, and reduce the incidence of PONV following parathyroidectomy with secondary hyperparathyroidism.Trial registration: ChiCTR1900027185. (Prospective registered). Initial registration date was 04/11/2019.