Bilateral Superficial Cervical Plexuses Block Combined With General Anesthesia for Elective Thyroid Surgery

Abstract

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.

Classification of the Patterns of the Emerging Branches of the Superficial Cervical Plexus

“…The second to fourth cervical nerves of the superficial cervical plexus innervate the dermatome level of the anterior and lateral aspects of the neck, therefore regional blocks of afore-mentioned plexus has been conducted to anesthetized the anterior triangle of the neck (Motamed et al, 2004;Karamanlioglu et al, 2005;Tarekegn et al, 2017). Clinically, regional anesthetic block of the cervical plexus is an increasingly available alternative for surgery of the, viz.…”

“…Clinically, regional anesthetic block of the cervical plexus is an increasingly available alternative for surgery of the, viz. thyroid surgery and is particularly used for carotid endarterectomy because of the possible overall lower incidence of morbidity and mortality neck (Santamaria et al, 2004;Suresh & Templeton;Pintaric et al, 2007;Tarekegn et al). Kim et al (2002) stated to complete an effective anaesthetization of the superficial cervical nerves, the anaesthetic should be inserted into the middle aspect of the posterior margin of the sternocleidomastoid muscle (Gupta et al, 2013).…”