TWO DIFFERENT APPROACHES FOR PREVENTION OF POST-THYROIDECTOMY PAIN: LOCAL WOUND INFILTRATION VERSUS BILATERAL SUPERFICIAL CERVICAL PLEXUS BLOCK
Saad S El-Taleb
Department of Surgery, Faculty of Medicine, Benghazi University, Benghazi
Mohamed Nagi
Abdul-haq Al-Mansoury
Rami Al-Shokri
Masoud A Lfeituri
Mohammad Qutait
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Abstract

Background: Regional anesthesia for post-thyroidectomy pain management has recently become a new trend that provides good quality of analgesia with a prolonged duration and fewer side effects than IV analgesia. We aimed to assess the bilateral superficial cervical plexus block (BSCB) versus local wound infiltration (LWI) after thyroid surgery with regard to postoperative analgesic efficacy.
Patients and Methods: Sixty adult patients of both sexes scheduled for elective thyroid surgery were randomly categorized into three equal groups. In the first group no regional block was performed (group-C), in the second group (group-L) the wound was infiltrated with 0.5% bupivacaine at the end of surgery, and the third group (group-B) received BSCB immediately after the induction of general anesthesia.
Pain intensity was evaluated by the eleven-category numerical rating scale (NRS) and the four-category verbal rating scale (VRS) at the first hour after surgery, and then every 4 hours for 24 hours postoperatively.
Results: NRS and VRS mean scores were significantly lower in groups (L) and (B) compared with the (C) group. The mean (± SD) of postoperative NRS scores was 3.82 (± 0.65), 2.01 (± 0.61), and 1.36 (± 0.70) in the (C), (L), and (B) groups respectively. The corresponding values measured by VRS were 2.49 (± 0.20), 1.71 (± 0.22), and 1.55 (± 0.23).
Conclusion: Although both techniques are effective for post-thyroidectomy pain management during the first postoperative 24 hours, BSCB provides a better analgesia and effectively decreases postoperative pethedine consumption more than LWI.

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