Ultrasound-guided bilateral superficial cervical plexus block is more effective than landmark technique for reducing pain from thyroidectomy

Abstract

PurposeThyroidectomy causes postoperative pain and patient discomfort. Bilateral superficial cervical plexus block is a regional anesthesia technique that can provide analgesia during and after surgery. This study aims to compare the effectiveness of ultrasound (US)-guided versus landmark (LM) technique for bilateral superficial cervical plexus block in thyroidectomy.Patients and methodsThirty-six patients undergoing thyroidectomy were divided into two groups randomly (n=18); either US-guided (US group) or LM technique (LM group) for bilateral superficial cervical plexus block. Patient-controlled analgesia was used to control postoperative pain. Intraoperative opioid rescue, postoperative visual analog scale (VAS) score and opioid consumption were measured.ResultsThe number of patients who required intraoperative opioid rescue was significantly lower in the US group (p≤0.05). There was no significant difference in postoperative VAS score at 3 hours (p>0.05), but postoperative VAS score at 6 and 24 hours was significantly lower in the US group (p≤0.05). Twenty-four hour postoperative opioid consumption was significantly lower in the US group (p≤0.05).ConclusionUltrasound-guided bilateral superficial cervical plexus block is more effective in reducing pain both intra- and postoperatively compared with landmark technique in patients undergoing thyroidectomy.

Ultrasound-Guided Selective Versus Conventional Block of the Medial Brachial Cutaneous and the Intercostobrachial Nerves

“…These results are not surprising, considering previous published data on ultrasound guidance; among many other examples, USG bilateral superficial cervical plexus blocks are more effective than landmark techniques for reducing pain following thyroidectomy. 15 The fact that in our study complete anesthesia was not obtained in all patients in the USG group can be explained by anatomical variations. The skin areas innervated by these nerves can vary from one individual to another 1 (Fig.…”

The analgesic efficacy of bilateral superficial cervical plexus block for thyroid surgery under general anesthesia: a prospective cohort study

“…In a recent Egyptian study that compared landmark and ultrasound-guided techniques found no difference in effectiveness and safety [25]. However, another study has concluded that an ultrasound-guided technique had superiority and explained by direct visualization of the nerves, adjacent structures and needle movement that results in faster, denser and longer block [26].…”

Analgesic efficacy of bilateral superficial cervical plexus block for thyroid surgery under general anesthesia; a prospective cohort study

“…In A recent Egyptian study that compared landmark and ultrasound-guided techniques found no difference in effectiveness and safety [24]. However, Senapathi et al has concluded that an ultrasound-guided technique had superiority and explained by direct visualization of the nerves, adjacent structures and needle movement that results in faster, denser and longer block [25].…”