Comparison of Preincisional and Postincisional 0.25% Levobupivacaine Infiltration in Thyroid Surgery

Abstract

Boyun cerrahisinde analjezi amaçlı yara yerinin lokal anestezik ile infiltrasyonu konusuna literatürde yeterince yer verilmemiştir. Gereç ve Yöntem: Tiroid cerrahisi planlanan 60 hasta rastgele iki gruba ayrıldı. Grup 1'de insizyon öncesi Grup 2'de cerrahi bitiminde yara yerine %0.25'lik levobupivakain uygulandı. Hastalar postoperatif dönemde ağrı ve yan etkiler açısından 24 saat takip edildi. İntraoperatif ve postoperatif opioid tüketimi, ilk analjezik gereksinim zamanı kaydedildi. 24 saat sonunda hasta memnuniyeti değerlendirildi. Bulgular: İnsizyon öncesi lokal anestezik uygulanan grupta daha düşük ağrı skorları ve analjezik tüketimi, daha geç analjezik ihtiyacı ve daha iyi hasta memnuniyet sağlandı. Tartışma: Lokal anestezik infiltrasyonu tiroid cerrahisi sonrası ağrı tedavisi için güvenilir ve pratik bir yöntemdir. İnsizyon öncesi lokal anestezik ile yara yeri infiltrasyonu daha iyi sonuçlar vermektedir.

Perioperative Analgesia for Patients Undergoing Thyroidectomy and Parathyroidectomy: An Evidence-Based Review

“…Of the 17 studies, seven (Teksoz et al, Choi et al, Miu et al, Kang et al, Kesisoglou et al, Ekinci et al, and Ahiskalioglu et al) reported statistically significant decreases in VAS and NRS postoperative pain scores. 23,25,27,28,35,36,40 Teksoz et al found lower VAS scores at 30 minutes, 1 hour, and at 8 hour postoperatively ( P = .03, P = .04, P = .005, respectively). 23 Kesisoglou similarly reported significantly decreased VAS scores at 0, 3, 6, 9, 12, and 24 hours after surgery ( P < .05).…”

“…The total amount of PCA consumption (10 mg/mL meperidine) also did not differ significantly ( P > .05). 33 In regards to rescue analgesic medications, four studies (Kang et al 28 [Fentanyl: 510.75 μg vs 422.50 μg; P < .05], Choi et al 25 [Fentanyl: 550.79 ± 46.46 μg vs 598.57 ± 55.58 μg; P < .01], Karthikeyan et al 31 [Morphine PCA: 30.70 ± 4.77 mg vs 0.85 ± 3.95 mg; P = .001], and Ekinci et al 36 [Tramadol: 72.4 ± 24.5 mg vs 91.5 ± 36.8 mg; P = .027]) reported statistically significant decreases in need for additional medication. Eight studies compared bilateral superficial cervical plexus block (BSCPB) encompassing 274 patients.…”

“…In total, 21 studies explored the role of local anesthetics in thyroid and parathyroid surgery. 11,12,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] Twenty of the studies were prospective RCTs and one study was retrospective. Extended details for these studies can be found in Supplemental 23,25,27,28,35,36,40 Teksoz et al found lower VAS scores at 30 minutes, 1 hour, and at 8 hour postoperatively (P = .03, P = .04, P = .005, respectively).…”

“…11,12,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] Twenty of the studies were prospective RCTs and one study was retrospective. Extended details for these studies can be found in Supplemental 23,25,27,28,35,36,40 Teksoz et al found lower VAS scores at 30 minutes, 1 hour, and at 8 hour postoperatively (P = .03, P = .04, P = .005, respectively). 23 Kesisoglou similarly reported significantly decreased VAS scores at 0, 3, 6, 9, 12, and 24 hours after surgery (P < .05).…”

Local Wound Infiltration for Thyroidectomized Patients in the Era of Multimodal Analgesia

“…Eighteen articles published between 1994 and April 2023 were identified [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Table 1 summarizes the reported trials.…”