Comparison of local anaesthetic wound infiltration and bilateral superficial cervical plexus block for thyroid and parathyroid surgery

Winstanley, Sarah; Parkinson, Fiona E.; Rassam, S.; Scott-Coombes, D; Stechman, Michael

doi:10.1097/00003643-201206001-00115

Cited by 5 publications

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“…Compared to blocking both the deep and superficial cervical plexus, it is easier to block only the superficial plexus bilaterally, which is also superior to local infiltration in terms of analgesic quality. 5 It is cost-effective and supports the principle of multimodal analgesia.…”

Section: Introductionmentioning

confidence: 76%

Bilateral Superficial Cervical Plexus Block in Thyroid Surgery with Intravenous versus Local Infiltration of Dexamethasone – A Randomized Single Blinded Comparative Study

Mondal¹,

Majumder²,

Halder

et al. 2023

Sri Lankan J Anaesthesiol

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Background: Post-operative pain for thyroid surgeries under general anaesthesia is inadequately managed. Bilateral superficial cervical plexus block (BSCPB) for thyroid surgery causes adequate analgesia without any significant side effects. Dexamethasone is commonly used in anaesthesia to prevent postoperative nausea and vomiting (PONV). The study objective was comparison of efficacy between add-on Dexamethasone intravenously and Ropivacaine alone in bilateral superficial cervical plexus block versus Dexamethasone added with Ropivacaine in the same block in producing postoperative analgesia and in preventing post-operative nausea vomiting. Methods: Randomized single-blind clinical study was done on eighty patients of 18-60 years of either sex, ASA I and II, scheduled for elective thyroid surgery under general anaesthesia. Patients were divided into two groups (n=40). In bilateral superficial cervical plexus block, Group DB (n=40) had received 20 ml Inj. Ropivacaine (0.25%) and 2ml (8 mg) Inj. Dexamethasone and Group DI (n=40) had received 20ml Inj. Ropivacaine (0.25%) and 2 ml of distilled water, along with 2 ml IV distilled water in DB group and Inj. Dexamethasone 2ml (8 mg) IV in DI group. Time of rescue analgesia with VAS (Visual Analogue Scale) score of that moment and incidence of PONV were noted up to 24 hrs post-operatively. Results: No statistically significant difference was found among the two groups in respect of time of rescue analgesia, VAS score and incidence of PONV. Conclusion: From our study, we conclude that different routes of administration of Inj. Dexamethasone during BSCPB has no extra benefit in respect of postoperative analgesia and incidence of PONV in thyroid surgery.

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Section: Introductionmentioning

confidence: 76%

Bilateral Superficial Cervical Plexus Block in Thyroid Surgery with Intravenous versus Local Infiltration of Dexamethasone – A Randomized Single Blinded Comparative Study

Mondal¹,

Majumder²,

Halder

et al. 2023

Sri Lankan J Anaesthesiol

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“…In this study we did not notice a significant difference in the immediate recovery room (PACU) pain score difference due to the difference in drug (ropivacaine) used as compared to ours. 7 Aweke Delayed time to first dose of rescue analgesia and lower pain scores in block group patients can help to justify that Superficial cervical plexus block is quite sufficient for analgesia for thyroid surgery.…”

Section: Discussionmentioning

confidence: 99%

Utility of bilateral superficial cervical plexus block in thyroidectomy patients for post-operative analgesia

Shah¹,

Kheskani²

2021

Int J Res Med Sci

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Background: Thyroidectomy is painful procedure hence multimodal analgesia is required. Superficial cervical plexus block can be used for analgesia in thyroid surgeries. USG guided cervical plexus block administration is safe and latest technique as a part of multimodal analgesia for thyroid surgery.Methods: After obtaining consent 60 ASA grade I-II adult patients undergoing elective thyroid surgery were included and randomly divided into two groups (group B)-0.25% bupivacaine and (group S)-normal saline. Induction and maintenance under general anesthesia carried out as per standard protocol. After Induction USG guided block was administered with the drug solution as per allocated group. After surgery, patients were extubated and shifted to recovery room. Vital parameters were monitored. Patients were asked about their pain based on the 11-point numerical rating scales (NRS) score. The NRS score and other variables were documented at 3rd hour, 6th hour, 12th hour, and 24th hour at wards after the end of surgery. Time since the end of surgery to the first analgesia request was documented together with total analgesia consumed in the first 24 hours. If NRS score was ≥4 inj. Tramadol iv in incremental doses of 25 mg was given until pain relieved.Results: Time to first dose of analgesia was higher in group B compared to group S. Total analgesic dose of tramadol during first 24 hours was lower in group B compared to group SConclusions: bilateral superficial cervical plexus block can be used as a part of multi-modal analgesia in patients of thyroidectoy.

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“…The result of this study is in line with the study done in France showing the lower pain score in the block group compared to the control group. This randomized controlled trial demonstrates that the median (IQR) pain score in the treatment group is 3 (0–10) and 5 (0–8) in the control with placebo group, respectively, p =0.01 [ 12 ]. The likely explanation for the similarity between two studies is the performance of the block, which was done after induction of anesthesia in both studies.…”

Section: Discussionmentioning

confidence: 99%

“…BSCPB is also easier and safer than the combined superficial and deep cervical plexus block [ 10 , 11 ]. It has also showed increased analgesic quality when compared with local infiltration [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Bilateral Superficial Cervical Plexus Block as Part of Postoperative Analgesia for Patients Undergoing Thyroidectomy in Empress Zewditu Memorial Hospital, Addis Ababa, Ethiopia

Aweke

Sahile

Abiy

et al. 2018

Anesthesiology Research and Practice

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Introduction The pain after thyroid surgery is considered of moderate intensity and short duration. Most trials showed significant reduction in pain intensity and severity of pain in patients for whom bilateral superficial cervical plexus block (BSCPB) was done. Objective To assess the postoperative analgesic effect of BSCPB for thyroid surgery. Methods Sixty six euthyroid patients were recruited and assigned to two groups (33 patients each). Group 1 BSCPB and Group 2 standard analgesia. The unpaired Student's t-test and Mann–Whitney test were used for comparison. Statistical significance was stated at p value < 0.05. Results The median postoperative pain score (NRS) was 3 in the BSCPB group and 5 in the control group (p=0.002). There was also statistically significant difference at 6th, 12th, and 24th hour showing a lower median pain score in the BSCPB group compared to the control group. The median time was (360 minutes) in the treatment group and (180 minutes) in the control group (p=0.0006). The median tramadol consumption within 24 hours is 0 mg in the BSCPB group compared to 100 mg in the control group (p=0.001). Conclusion and Recommendation BSCPB done for thyroidectomy under general anesthesia decreases the postoperative pain score, total analgesia consumption, and time to first analgesia request.

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Comparison of local anaesthetic wound infiltration and bilateral superficial cervical plexus block for thyroid and parathyroid surgery

Cited by 5 publications

References 0 publications

Bilateral Superficial Cervical Plexus Block in Thyroid Surgery with Intravenous versus Local Infiltration of Dexamethasone – A Randomized Single Blinded Comparative Study

Bilateral Superficial Cervical Plexus Block in Thyroid Surgery with Intravenous versus Local Infiltration of Dexamethasone – A Randomized Single Blinded Comparative Study

Utility of bilateral superficial cervical plexus block in thyroidectomy patients for post-operative analgesia

Effectiveness of Bilateral Superficial Cervical Plexus Block as Part of Postoperative Analgesia for Patients Undergoing Thyroidectomy in Empress Zewditu Memorial Hospital, Addis Ababa, Ethiopia

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