Prevention of Postoperative Pain After Thyroid Surgery: A Double-Blind Randomized Study of Bilateral Superficial Cervical Plexus Blocks

Dieudonné, Nathalie; Gomola, Alexandra; Bonnichon, P; Ozier, Yves

doi:10.1097/00000539-200106000-00038

Cited by 128 publications

(128 citation statements)

References 12 publications

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“…This pain may be treated with NSAIDs or opioids. 1,2 Nonsteroidal anti-inflammatory drugs are commonly used analgesics for minor surgery and are useful adjunctive analgesics in patients undergoing major surgery, decreasing pain and opioid requirements. 17 However, their use in some patients may be limited by adverse renal, gastrointestinal, and hematological effects.…”

Section: Discussionmentioning

confidence: 99%

“…Post-thyroidectomy pain has frequently been treated with nonsteroidal anti-inflammatory drugs (NSAIDs) or opioids. 1,2 Lornoxicam is a potent new NSAID of the oxicam class that has been shown to be effective and well tolerated in the treatment of postoperative pain. [3][4][5] The short plasma half-life (three to five hours) of lornoxicam may provide advantages over other NSAIDs.…”

Section: Conclusion : L'infiltration Dans Le Site D'incision Avec Unementioning

confidence: 99%

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Infiltration with ropivacaine plus lornoxicam reduces postoperative pain and opioid consumption

Karamanlıoğlu

Turan

Memiş

et al. 2005

Can J Anesth/J Can Anesth

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Purpose:To compare efficacy and patient outcome of wound infiltration with ropivacaine, lornoxicam, or their combination for control of pain following thyroid surgery. Methods:Eighty patients underwent thyroid surgery were randomly assigned to one of four groups. Before skin closure, local tissues were infiltrated with 12 mL saline in Group S, with 10 mL of ropivacaine 0.75% plus 2 mL saline in Group R, with 2 mL of lornoxicam (8 mg) plus 10 mL saline in Group L, and with 10 mL ropivacaine 0.75% plus 2 mL lornoxicam (8 mg) in Group RL. Pain scores, total and incremental meperidine consumption were recorded at 30 min, one, two, three, four, six, eight, 12, 18, and 24 hr postoperatively. Time to first analgesic requirement, patient satisfaction, and duration of hospital stay were also compared after surgery. Results:The pain scores in Group RL were significantly lower in the first 12 hr than in Group S, and in the first four hours than in Groups R and L (P < 0.01). The time to first analgesic requirement was significantly longer (14.8 ± 8.4 hr vs 5.9 ± 5.2 hr; P < 0.01), the total pethidine consumption was significantly less than Group S (34.0 ± 33.0 mg vs 78.0 ± 29.8 mg; P<0.001), return of gastrointestinal function, ambulation time, length of hospital stay (P < 0.05) were significantly shorter, and patient satisfaction (P < 0.01) was significantly better in Group RL than in Group S (P < 0.05). Conclusion: Wound infiltration with ropivacaine 0.75% plus lornoxicam 8 mg combination improved postoperative pain control and patient comfort, and decreased the need for opioids than the use of either drug alone. (14,8 ± 8,4 h vs 5,9 ± 5,2 h ; P < 0,01), la consommation totale de péthidine a été plus basse que dans le groupe S (34,0 ± 33,0 mg vs 78,0 ± 29,8 mg ; P < 0,001) Objectif

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Section: Discussionmentioning

confidence: 99%

Section: Conclusion : L'infiltration Dans Le Site D'incision Avec Unementioning

confidence: 99%

Infiltration with ropivacaine plus lornoxicam reduces postoperative pain and opioid consumption

Karamanlıoğlu

Turan

Memiş

et al. 2005

Can J Anesth/J Can Anesth

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“…Dieudonne et al, 6 Aunac et al 7 and Lubenow et al 8 have stated that cervical segment anesthesia reduces the need for postoperative dipyrone, which indicates lower postoperative stress. In our study, however, this alleged superiority of SCPB over GA was not confirmed, as the same number of patients requested analgesics.…”

Section: Discussionmentioning

confidence: 98%

Comparação da anestesia geral e bloqueio do plexo cervical superficial em tireoidectomias parciais

Mamede

Raful

2008

Rev. Bras. Otorrinolaringol.

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Thyroi dectomy under the effect of superficial cervical plexus block (SCPB) has met resistance. Aim: to compare variables in patients submitted to hemithyroidectomy under the effect of general anesthesia (GA) and SCPB. Case report and Methods: GA was used in 21 patients, and SCPB was used in another 21 patients. Following sedation, marcaine 0.5% with vasoconstrictor was used in the SCPB group. Intraoperative sedation with diazepam and metoprolol to control arterial pressure and cardiac frequency was given as needed. GA followed the standard method in the unit. Results: We found significant results (p<0.05, Student's ttest) for surgery time (GA -111.4 min; SCPB -125.5 min), anesthesia time (GA -154.1 min; SCPB -488.6 min), time in the surgery room (GA -15 min; SCPB -1 min), treatment costs (GA -R$203.2; SCPB -R$87.4), presence of bradycardia (GA -0; SCPB -23.8%) and laryngotracheal injury (GA -51; SCPB -0 %). We also found the following non-significant results: hospitalization time (GA -17.3; SCPB -15.1 hours); bleeding volume (GA -41,9 g; SCPB -47.6 g), size of the operative specimen (GA -52.1 cm3; SCPB -93.69 cm3) and patient satisfaction level (GA -3.8; SCPB -3.9). Conclusion: Although the incidence of bradycardia was higher (23.8%), SCPB was done for the resection of tumors measuring up to 348 cm3, at a lower cost and with no laryngotracheal injuries; these were present in 51% of patients undergoing GA.

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“…[18][19][20][21][22][23][24] Several studies have shown that the SCPB not only improves pain control after thyroidectomy and carotid endarterectomy, [18][19][20][21][22][23][24] but it also decreases PONV after thyroidectomy. 18 Nevertheless, we did not find any differences in postoperative opioid consumption between the two groups.…”

Section: Discussionmentioning

confidence: 99%

Effect of superficial cervical plexus block on postoperative quality of recovery after anterior cervical discectomy and fusion: a randomized controlled trial

Mariappan

Mehta

Massicotte

et al. 2015

Can J Anesth/J Can Anesth

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Effect of superficial cervical plexus block on postoperative quality of recovery after anterior cervical discectomy and fusion: a randomized controlled trial L'effet d'un bloc du plexus cervical superficiel sur la qualité de la récupération postopératoire après une discectomie cervicale antérieure et fusion: une étude randomisée contrôlée Abstract Purpose Spine surgeries are increasingly being performed as a day or short-stay surgery programs. Peripheral nerve block provide site-specific pain relief with few side effects, thereby reducing surgical stress and enhancing quality of recovery. The aim of our study was to determine the effect of a superficial cervical plexus block (SCPB) on postoperative quality of recovery and analgesia in patients undergoing elective anterior cervical discectomy and fusion (ACDF). Methods After Research Ethics Board approval, we enrolled adults ([ 18 yr) scheduled for elective single-or two-level ACDF in this randomized double-blind clinical trial. Participants were randomized to receive either a SCPB (0.25% bupivacaine, 10 mL) or No Block. The primary outcome measure was the quality of recovery at 24 hr, measured using the 40-item quality of recovery questionnaire (QoR-40). In addition, comparisons between groups were also made for postoperative opioid consumption and discharge times. Results Forty-six patients were randomized to receive either a SCPB block (n = 23) or No Block (n = 23). Median [interquartile range] aggregated global QoR-40 scores at 24 hr were significantly greater in the SCPB group, indicating good quality of recovery compared with the No Block group (179 [116-195] vs 157 , respectively; median difference, 22; 95% confidence interval [CI], 7 to 34; P = 0.002]. There were no differences between the SCPB and the No Block group with regard to mean (standard deviation) postoperative opioid consumption at 24 hr [22.9 (13.6) mg vs 24.6 (9.5) mg, respectively; mean difference 1.7; 95% CI, -5.2 to 8.7; P = 0.620] and the number of patients discharged within 24 hr (15 vs 12, respectively; P = 0.550). Conclusion We showed that preoperative SCPB is an effective strategy for improving the early quality of recovery in patients undergoing single-or two-level ACDF. Nevertheless, there was no impact on opioid consumption or discharge times. This trial was registered at www.clinicaltrials.gov (NCT01662219). RésuméObjectif Les chirurgies de la colonne sont de plus en plus souvent réalisées en ambulatoire ou dans le cadre de programmes chirurgicaux de courte durée. Les blocs des nerfs périphériques procurent un soulagement de la douleur localisé et entraînent peu d'effets secondaires, Author contributions Ramamani Mariappan and Lashmi Venkatraghavan helped with the study design. Ramamani Mariappan, Jigesh Mehta, Eric Massicotte, and Pirjo Manninen helped conduct the study. Ramamani Mariappan and Jigesh Mehta contributed to the data entry. Ramamani Mariappan, Mahesh Nagappa, and Lashmi Venkatraghavan contributed to the data analysis. Ramamani Mariappan, Jigesh Mehta, Eric Massicott...

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Prevention of Postoperative Pain After Thyroid Surgery: A Double-Blind Randomized Study of Bilateral Superficial Cervical Plexus Blocks

Cited by 128 publications

References 12 publications

Infiltration with ropivacaine plus lornoxicam reduces postoperative pain and opioid consumption

Infiltration with ropivacaine plus lornoxicam reduces postoperative pain and opioid consumption

Comparação da anestesia geral e bloqueio do plexo cervical superficial em tireoidectomias parciais

Effect of superficial cervical plexus block on postoperative quality of recovery after anterior cervical discectomy and fusion: a randomized controlled trial

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