Bilateral Superficial Cervical Plexus Block Combined with General Anesthesia Administered in Thyroid OperationsReport as inadecuate




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World Journal of Surgery

, Volume 34, Issue 10, pp 2338–2343

First Online: 10 July 2010

Abstract

BackgroundWe investigated the analgesic efficacy of bilateral superficial cervical plexus block in patients undergoing thyroidectomy and to determine whether it reduces the adverse effects of general anesthesia.

MethodsWe prospectively recruited 162 patients who underwent elective thyroid operations from March 2006 to October 2007. They were randomly assigned to receive a bilateral superficial cervical block 12 ml per side with isotonic saline group A; n = 56, bupivacaine 0.5% group B; n = 52, or levobupivacaine 0.5% group C; n = 54 after induction of general anesthesia. The analgesic efficacy of the block was assessed with: intraoperative anesthetics desflurane, numbers of patients needing postoperative analgesics, the time to the first analgesics required, and pain intensity by visual analog scale VAS. Postoperative nausea and vomiting PONV for 24 h were also assessed by the -PONV grade.- We also compared hospital stay, operative time, and discomfort in swallowing.

ResultsThere were no significant differences in patient characteristics. Each average end-tidal desflurane concentration was 5.8, 3.9, and 3.8% in groups A, B, and C, respectively p < 0.001. Fewer patients in groups B and C required analgesics A: B: C = 33:8:7; p < 0.001, and it took longer before the first analgesic dose was needed postoperatively group A: B: C = 82.1:360.8:410.1 min; p < 0.001. Postoperative pain VAS were lower in groups B and C for the first 24 h postoperatively p < 0.001. Incidences of overall and severe PONV were lower, however, there were not sufficient numbers of patients to detect differences in PONV among the three groups. Hospital stay was shorter in group B and group C p = 0.011. There was no significant difference in operative time and postoperative swallowing pain among the three groups.

ConclusionsBilateral superficial cervical plexus block reduces general anesthetics required during thyroidectomy. It also significantly lowers the severity of postoperative pain during the first 24 h and shortens the hospital stay.

This work was presented at the IAES Scientific Congress, Adelaide, Australia; September 2009.

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Author: Ming-Lang Shih - Quan-Yang Duh - Chung-Bao Hsieh - Yao-Chi Liu - Chueng-He Lu - Chih-Shung Wong - Jyh-Cherng Yu - Chun-Chan

Source: https://link.springer.com/article/10.1007/s00268-010-0698-7







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