ANALGESIC EFFICACY OF COMBINATION OF BILATERAL SUPERFICIAL CERVICAL PLEXUS BLOCK AND STANDARD ANALGESIA WITH STANDARD ANALGESIA ALONE IN PATIENTS UNDERGOING THYROID CANCER SURGERY. A RANDOMISED-CONTROLLED TRIAL
Abstract
Purpose: This study aimed to determine analgesic efficacy of a combination of bilateral superficial cervical plexus block (BLSCPB) and standard analgesia with standard analgesia alone in patients undergoing thyroid cancer surgery under general anaesthesia.
Materials and Methods: It was a randomised-controlled trial conducted at the Anaesthesia Department of the Shaukat Khanum Memorial Cancer Hospital, Lahore. A sample size of 60 patients (30 patients in each group) was calculated with 95% confidence interval and power of 80%.
Results: The mean pain-free duration for the Group A (BLSCPB group) was 72 min (SD 30.1) compared to 53 min (standard deviation 30.3) for the Group B. This shows a significant reduction in pain-free duration in Group A. Average NRS pain score in the Group A at q 0, 30, 60, 90 and 120 min was (0.83, 1.83, 0.23, 1.76 and 1.49), whereas the average pain score on NRS in the Group B at the same time interval mentioned above for Group A was (2.1, 2.73, 4.53, 2.44 and 1.85)
Conclusion: Administration of BLSCPB resulted in superior analgesia after thyroid cancer surgery.
Key words: Analgesia, cervical plexus block, post-operative pain, regional anaesthesia, thyroidectomy
References
Santosh BS, Mehandale SG. Does dexmedetomidine improve analgesia of superficial cervical plexus block for thyroid surgery? Indian J Anaesth 2016;60:34-8.
Motamed C, Merle JC, Yakhou L, et al. Intraoperative i.v. Morphine reduces pain scores and length of stay in the post anaesthetic care unit after thyroidectomy. Br J Anaesth 2004;93:306-7.
Gozal Y, Shapira SC, Gozal D, et al. Bupivacaine wound infiltration in thyroid surgery reduces postoperative pain and opioid demand. Acta Anaesthesiol Scand 1994;38:813-5.
Sonner JM, Hynson JM, Clark O, et al. Nausea and vomiting following thyroid and parathyroid surgery. J Clin Anesth 1997;9:398-402.
Soltani G, Molkizadeh A, Amini S. Effect of intravenous acetaminophen (paracetamol) on hemodynamic parameters following endotracheal tube intubation and postoperative pain in caesarian section surgeries. Anesth Pain Med 2015;5:e30062.
Shih ML, Duh QY, Hsieh CB, et al. Bilateral superficial cervical plexus block combined with general anesthesia administered in thyroid operations. World J Surg 2010;34:2338-43.
Herbland A, Cantini O, Reynier P, et al. The bilateral superficial cervical plexus block with 0.75% ropivacaine administered before or after surgery does not prevent postoperative pain after total thyroidectomy. Reg Anesth Pain Med 2006;31:34-9.
Ivanec Z, Mazul-Sunkol B, Lovricević I, et al. Superficial versus combined (deep and superficial) cervical plexus block for carotid endarterectomy. Acta Clin Croat 2008;47:81-6.
Andrieu G, Amrouni H, Robin E, et al. Analgesic efficacy of bilateral superficial cervical plexus block administered before thyroid surgery under general anaesthesia. Br J Anaesth 2007;99:561-6.
Suh YJ, Kim YS, In JH, et al. Comparison of analgesic efficacy between bilateral superficial and combined (superficial and deep) cervical plexus block administered before thyroid surgery. Eur J Anaesthesiol 2009;26:1043-7.
Eti Z, Irmak P, Gulluoglu BM, et al. Does bilateral superficial cervical plexus block decrease analgesic requirement after thyroid surgery? Anesth Analg 2006;102:1174-6.
Hutschala D, Mascher H, Schmetterer L, et al. Clonidine added to bupivacaine enhances and prolongs analgesia after brachial plexus block via a local mechanism in healthy volunteers. Eur J Anaesthesiol 2004;21:198-204.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors retain copyright and grant the Journal of Cancer & Allied Specialties (JCAS) right-of-first publication. In addition, the work will be simultaneously licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International license. This license allows others to share the work in whole or part (for non-commercial purpose), with an acknowledgement of the work’s authorship and initial publication in JCAS.
Furthermore, authors are free to enter into separate contractual arrangements for the non-exclusive distribution of the journal’s published version of the work, with an acknowledgement of its initial publication in this journal.
Authors are permitted and encouraged to share their work online or in medical or scientific conferences prior to or during submission process.