Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2019.06.012
Brazilian Journal of Anesthesiology
Scientific Article

Perioperative analgesic efficacy of bilateral superficial cervical plexus block in patients undergoing thyroidectomy: a randomized controlled trial

Eficácia analgésica perioperatória do bloqueio bilateral do plexo cervical superficial em pacientes submetidos à tireoidectomia: estudo clínico randomizado

Alkan Karakış, Hakan Tapar, Zeki Özsoy, Mustafa Suren, Serkan Dogru, Tuğba Karaman, Serkan Karaman, Aynur Sahin, Hasan Kanadlı

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Abstract

Introduction
Bilateral Superficial Cervical Plexus Block (BSCPB) is a common method used for analgesia in thyroid surgery. We investigated the analgesic efficacy of bilateral superficial cervical plexus block in the intraoperative and postoperative periods.

Materials and methods
Patients (n = 46) undergoing thyroidectomy were randomly separated into the following 2 groups: the General Anesthesia Group (GA; n = 23) and the general anesthesia plus BSCPB Group (GS; n = 23). The intraoperative analgesic requirement (remifentanil) and Visual Analog Scale (VAS) score at multiple time points during the postoperative period (after extubation, at 15 and 30 minutes and 1, 2, 6, 12, 24 and 48 hours post operation) were evaluated. Total tramadol and paracetamol consumption as well as the amount of ondansetron used was recorded.

Results
The intraoperative remifentanil requirement was significantly lower in the GS Group than in the GA Group (p = 0.009). The postoperative pain scores were significantly lower in the GS Group than in the GA Group at 15 (p < 0.01) and 30 (p < 0.01) minutes and 1 (p < 0.01), 2 (p < 0.01), 6 (p < 0.01), 12 (p < 0.01) and 24 (p = 0.03) hours. The postoperative tramadol requirement was significantly lower in the GS Group than in the GA Group (p = 0.01). The number of patients that used ondansetron was significantly lower in the GS Group than in the GA Group (p = 0.004).

Conclusion
We concluded that BSCPB with 0.25% bupivacaine reduces the postoperative pain intensity and opioid dependency in thyroid surgery patients.

Keywords

Superficial cervical plexus block; Thyroidectomy; Anesthesia and analgesia

Resumo

Introdução
O bloqueio bilateral do plexo cervical superficial (BPCS) é um método comumente usado para analgesia em tireoidectomia. Avaliamos a eficácia analgésica do bloqueio bilateral do BPCS nos períodos intraoperatório e pós‐operatório.

Materiais e métodos
Os pacientes (n = 46) submetidos à tireoidectomia foram randomicamente separados em dois grupos para receber anestesia geral (Grupo GA; n = 23) e anestesia geral mais bloqueio bilateral do BPCS (Grupo GS; n = 23). Avaliamos a necessidade de analgésico no intraoperatório (remifentanil) e os escores VAS (Visual Analog Scale) em vários momentos no pós‐operatório (após a extubação, aos 15 e 30 minutos e em 1, 2, 6, 12, 24 e 48 horas de pós‐operatório). O consumo total de tramadol e paracetamol e a quantidade usada de ondansetrona foram registrados.

Resultados
A necessidade de remifentanil no intraoperatório foi significativamente menor no Grupo GS do que no Grupo GA (p = 0,009). Os escores de dor pós‐operatória foram significativamente menores no Grupo GS do que no grupo GA aos 15 (p < 0,01) e 30 (p < 0,01) minutos e em 1 (p < 0,01), 2 (p < 0,01), 6 (p < 0,01), 12 (p < 0,01) e 24 (p = 0,03) horas de pós‐operatório. A necessidade de tramadol no pós‐operatório foi significativamente menor no Grupo GS do que no grupo GA (p = 0,01). O número de pacientes que recebeu ondansetrona foi significativamente menor no Grupo GS do que no Grupo GA (p = 0,004).

Conclusão
O bloqueio bilateral do BPCS com bupivacaína a 0,25% reduz a intensidade da dor pós‐operatória e a dependência de opioides em pacientes submetidos à tireoidectomia.

Palavras-chave

Bloqueio do plexo cervical superficial; Tireoidectomia; Anestesia e analgesia

References

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