Indian Journal of Endocrine Surgery and Research

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VOLUME 13 , ISSUE 1 ( September, 2018 ) > List of Articles

Original Article

The effect of bilateral superficial cervical block in the prevention of post operative pain, nausea and vomiting in patients undergoing thyroidectomy – a randomised controlled study

P Sujeev, M Ramamani

Citation Information : Sujeev P, Ramamani M. The effect of bilateral superficial cervical block in the prevention of post operative pain, nausea and vomiting in patients undergoing thyroidectomy – a randomised controlled study. 2018; 13 (1):8-15.

DOI: 10.5005/jp-journals-10088-11128

License: CC BY-NC 4.0

Published Online: 10-02-2021

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: Thyroidectomy is a commonly performed surgical procedure in the department of Surgical Endocrinology. It is associated with a significant incidence of post operative pain and nausea & vomiting (PONV). Opioid analgesic use in the intra operative and post operative period is one of the causes for PONV, which is one of the most common and distressing symptom in our experience. Bilateral superficial cervical plexus block has been used in thyroidectomy for its analgesic effects and many studies show reduced pain and opioid requirement in these patients. However, it is unclear if this translates into a decrease in the incidence of PONV as all previous studies have routinely used opioid analgesics in the post operative period Objectives: We prospectively recruited 100 patients who underwent thyroidectomy (hemi, completion, total thyroidectomy) without neck dissection. The patients were randomised to receive either bilateral superficial cervical plexus block (Intervention group n = 50) using 20 ml of 0.25% bupivacaine (10 ml on each side) or no block (no intervention, n = 50), after introduction of general anaesthesia. The post operative pain and PONV scores were assessed for all the patients during the first 48 hours after surgery and it was compared between the two groups. Methods: The study was a randomised controlled trial between cervical plexus block and no intervention. Patients undergoing thyroidectomy with no lateral neck dissection were enrolled. A total of 100 patients were enrolled in the study with 50 in each arm. The end points studied were pain scores and PONV scores in the two groups. These patients were followed up in the ward for the next 48 hours with pain scores and PONV scores. Results: The demographic and clinical characteristics were similar in both the groups. The pain and PONV scores in both groups showed a decline with time. However, there was no statistically significant difference between the two groups. Bilateral superficial cervical plexus block before thyroidectomy did not significantly decrease the post operative pain scores or the incidence of post operative nausea and vomiting. From our study results, we do not recommend its routine use in thyroid surgery for prevention of pain or post operative nausea and vomiting.


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