Randomized Controlled Trial on the Efficacy of Bilateral Superficial Cervical Plexus Block in Thyroidectomy

Karthikeyan, Vilvapathy Senguttuvan; Sistla, Sarath Chandra; Badhe, Ashok Shankar; Thulasingam, Mahalakshmy; Rajkumar, Natesan; Ali, Sheik Manwar; Gopalakrishnan, Surianarayana

doi:10.1111/papr.12022

Cited by 40 publications

(42 citation statements)

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“…Addition of adrenaline can not only prolong the effect of the block but also reduce the peak plasma levels of local anaesthetics [10,12]. Clonidine is also known to enhance the efficacy and duration of the block [14] and has been found to decrease postoperative nausea and vomiting [15]. BSCB alone and in combination with ketamine infusion has been successfully used as a sole anaesthetic for thyroid surgery [16].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Analgesic Effect of Bilateral Superficial Cervical Plexus Block for Thyroid Surgery: A Comparison of Presurgical with Postsurgical Block

Kale

Shastri

et al. 2015

Indian J Surg

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Section: Discussionmentioning

confidence: 99%

Evaluation of the Analgesic Effect of Bilateral Superficial Cervical Plexus Block for Thyroid Surgery: A Comparison of Presurgical with Postsurgical Block

Kale

Shastri

et al. 2015

Indian J Surg

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“…For the management of postoperative pain following throidectomy, NSAIDs and/or opioid analgesics are used commonly in practice. To decrease the postoperative pain and reduce the need for analgesics following thyroidectomy surgery, preoperative oral controlled-release analgesia with opioids and alternative regional techniques such as incisional local anesthesia, intraoperative bilateral superficial and/or deep cervical plexus block, local wound infiltration with local analgesia have also been suggested recently (20,21,23,(27)(28)(29). Performing thyroidectomy under local or regional anesthesia rather than general anesthesia has also been suggested to control postoperative pain (30).…”

Section: Discussionmentioning

confidence: 99%

“…However, there are limited studies on the use of local anesthetics in neck surgery. Bupivacaine has been used for preoperative wound infiltration (19), and intraoperative bilateral superficial cervical plexus block in thyroidectomy to prevent postoperative pain (20,21). However, there is ongoing debate on the effectiveness and the route of application of bupivacaine to control pain following thyroidectomy (17,19,20,22,23).…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, Herbland et al (32) found that bilateral superficial cervical plexus block with ropivacaine did not prevent postoperative pain after total thyroidectomy. However, Karthikeyan et al (20) reported that intraoperative bilateral superficial cervical plexus block with bupivacaine was effective in reducing postoperative pain and analgesic requirements in thyroidectomy.…”

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confidence: 99%

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Local bupivacaine for postoperative pain management in thyroidectomized patients: A prospective and controlled clinical study

Dumlu¹,

Tokaç²,

Öcal³

et al. 2016

UCD

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Objective: We aimed to evaluate the effect of bupivacaine and to compare the routes of administration of bupivacaine in the management of postoperative incision site pain after thyroidectomy. Material and Methods:Consecutive patients who were planned for thyroidectomy surgery were randomized into three groups of 30 patients each: Group 1 (control group): standard thyroidectomy surgery without additional intervention; Group 2 (paratracheal infiltration with bupivacaine): following thyroidectomy, 0.25% bupivacaine was applied on the surgical area; Group 3 (subcutaneous infiltration with bupivacaine): following thyroidectomy, 0.25% bupivacaine was injected into the cutaneous, subcutaneous region and fascia of the surgical area. Postoperative pain was evaluated by a visual analog scale (VAS) at 1 st , 4 th , and 12 th hours after thyroidectomy. Total daily requirement for additional analgesia was recorded. Results:The mean age of 90 patients was 44.37±13.42 years, and the female:male ratio was 62:28. There was no difference between study groups in terms of age, thyroid volume, TSH and T4 levels. VAS score of patients in paratracheal infiltration with bupivacaine group was significantly lower than control group patients at 1 st , 4 th and 12 th hours following thyroidectomy (p=0.030, p=0.033, p=0.039, respectively). The need for analgesics was significantly lower in both paratracheal infiltration and subcutaneous infiltration groups than the control group (86.7%, 83.0%, and 73.3%, respectively, p=0.049). Conclusions:Intraoperative local bupivacaine application is effective in decreasing postoperative pain in patients with thyroidectomy.

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“…Patients may complain of moderate pain that is generally of short duration following thyroid surgery but none the less, some patients ask for analgesics in the form of narcotics or non-opioid analgesics during the first day after thyroid operations. Postoperative pain management after thyroid surgery has also gained more importance and attention because thyroid surgery is recently being performed on a day case basis [2].…”

Section: Introductionmentioning

confidence: 99%

Analgesic efficacy of ultrasound guided versus landmark-based bilateral superficial cervical plexus block for thyroid surgery

Hassan

Hashim

2017

Egyptian Journal of Anaesthesia

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a b s t r a c tBackground: The use of bilateral superficial cervical plexus block (BSCPB) to provide analgesia for thyroid operations remains debatable. This study was done to assess the analgesic efficacy and safety of ultrasound (US) guided or landmark-based BSCPB, performed under general anesthesia, compared to systemic narcotics in thyroid surgery. Patients and methods: A total of 69 patients ASA I and II scheduled for thyroid surgery were randomly assigned into three groups (23 patients each): Group (US) received US guided BSCPB. Group (LM) received landmark-based BSCPB. In both groups, the block was performed under general anesthesia and before surgery using 0.5% bupivacaine 12 ml on each side. Group (C) who didn't receive any block. We measured intra-operative hemodynamics and fentanyl requirements. We also measured postoperative analgesia within 24 h of surgery as regard: pethidine consumption, visual analogue scale (VAS) pain scores and time to first rescue analgesic demand. Postoperative nausea and vomiting (PONV) and other adverse events were noted as well.Results: There was a significant reduction in systolic blood pressure (SBP) and heart rate (HR) in groups US and LM compared with group C. Intra-operative fentanyl requirements were significantly increased in group C compared to groups US and LM. Time to first analgesic request was significantly longer in groups US and LM than in group C. Postoperative pethidine consumption and VAS scores, measured during the first postoperative day, were significantly higher in group C than groups US and LM. No significant difference was noted between the three groups regarding PONV. No other adverse events were recorded. No significant differences were noted between groups US and LM. Conclusion: BSCPB (US guided or landmark-based), performed under general anesthesia, effectively decreased peri-operative analgesic requirements in thyroid operations. However, there was no significant difference in analgesic efficacy or safety between US guided and landmark based BSCPB.

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Randomized Controlled Trial on the Efficacy of Bilateral Superficial Cervical Plexus Block in Thyroidectomy

Abstract: BSCPB with 0.25% bupivacaine with or without clonidine is effective in reducing both intraoperative and postoperative pain and analgesic requirements in thyroidectomy, and adding clonidine to bupivacaine reduces postoperative vomiting.

Cited by 40 publications

References 14 publications

Evaluation of the Analgesic Effect of Bilateral Superficial Cervical Plexus Block for Thyroid Surgery: A Comparison of Presurgical with Postsurgical Block

Evaluation of the Analgesic Effect of Bilateral Superficial Cervical Plexus Block for Thyroid Surgery: A Comparison of Presurgical with Postsurgical Block

Local bupivacaine for postoperative pain management in thyroidectomized patients: A prospective and controlled clinical study

Analgesic efficacy of ultrasound guided versus landmark-based bilateral superficial cervical plexus block for thyroid surgery

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