Evaluating the Analgesic Efficacy of Conventional versus Ultrasound-guided Bilateral Superficial Cervical Plexus Block in Thyroid Surgeries: A Randomized Controlled Trial

Abstract

Objectives: Thyroid surgery is a painful procedure for which bilateral superficial cervical plexus block (BSCPB) can be given to potentially reduce postoperative pain. Ultrasound guidance provides real-time visualization of anatomical structures, needle movement, and accurate deposition of local anesthetic in close proximity to nerves, thus making the procedure safer and more effective. Our aim was to compare the analgesic efficacy of ultrasound-guided versus the landmark technique of BSCPB in patients undergoing thyroid surgeries. Materials and Methods: Sixty patients (19–64 years) undergoing thyroid surgeries were divided into two groups – Group US (n = 30): patients undergoing ultrasound-guided BSCPB and Group LM (n = 30): patients undergoing landmark technique for BSCPB. Visual Analog Scale (VAS) pain score at 0, 2, 4, 6, 12, and 24 h, total fentanyl requirement during the intraoperative period, time taken to first rescue analgesia demand, and total tramadol consumption during the first 24 h postoperatively were compared among the two groups. Results: In Group US, there was less intraoperative fentanyl requirement (102.07 ± 18.96 μg vs. 113.33 ± 22.65 μg in group LM, P - 0.037), lower VAS pain score at 0, 2, 4, 6, and 12 h (P = 0.03, <0.001, 0.017, 0.046, and 0.048, respectively), longer time taken to first rescue analgesia demand (491.23 ± 123.43 min vs. 291.00 ± 119.77 min in LM group, P < 0.001), and lesser total tramadol consumption during first 24 h postoperatively (51.67 ± 6.34 mg vs. 75.83 ± 24.11 mg in Group LM, P < 0.001). Conclusions: We conclude that ultrasound-guided BSCPB is more effective than landmark technique for reducing pain both intra and postoperatively in patients undergoing thyroid surgery.