Role of Bilateral ultrasound guided superficial cervical plexus block as a part of enhanced recovery after thyroid surgery

Abstract

Methods: The current study was a prospective randomized controlled double blinded study was conducted at Tanta University Hospitals for patients admitted to undergo elective thyroid surgeries for a period of 9 months. Inclusion criteria were patients aged 21 -65 y and ASA physical status I or II, prepared for elective thyroid operation were encouraged to contribute to the study cases were divided to 2 equal groups (50 cases each) in a random manner: Group I (Control group): Sham Technique: the cases received general anaesthesia plus US guided Bilateral SCPB with 10 ml NaCl 0.9% were injected on both sides. Group II (Study group): cases received general anaesthesia plus US guided Bilateral SCPB with a total volume of 10 ml containing Bupivacaine 0.25% was injected (5 ml Bupivacaine 0.5%- and 5-ml NaCl 0.9% bilaterally).Results: Postoperative QOR-15 score was significantly elevated in group II in comparison with group I; P value less than 0.001. Time to 1st rescue analgesia was significantly higher in group II in comparison with group I; P value < 0.001. VAS was significantly elevated in group I at 30min, 2hrs, 4hrs and 6 hrs in comparison with Group II: P value less than 0.001. nevertheless, no statistically significant differences were found between both groups at 8hr, 10hr, 12hr, 18hr and 24hr; P value < 0.005. Postoperative opioid consumption was significantly reduced in group II in comparison with group I: P value less than 0.001.Pre and post-operative values of diaphragmatic excursion revealed that there was no statistically significant differences either in the same group or between the 2 groups. Conclusions: Patients undergoing thyroid surgery showed improved global quality of recovery after preoperative US guided BSCPB. It decreased POP score, diminished intraoperative analgesic consumption, reduced postoperative morphine consumption, and maintained diaphragmatic excursion.