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Wound infiltration with bupivacaine 0.5% with or without adrenaline does not decrease pain after thyroidectomy. A

Ayman A Mismar1, Mohammad I Mahseeri, Mutasim A Al-Ghazawi

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Local wound infiltration with bupivacaine, with or without adrenaline, did not significantly reduce pain after thyroidectomy. Pain scores were similar across all groups, indicating limited benefit for this specific surgical pain management technique.

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Area of Science:

  • Anesthesiology
  • Surgical Pain Management

Background:

  • Thyroidectomy is a common surgical procedure.
  • Postoperative pain management is crucial for patient recovery.
  • Local wound infiltration is a potential method for pain control.

Purpose of the Study:

  • To evaluate the efficacy of local wound infiltration with bupivacaine, with and without adrenaline, on pain perception following thyroidectomy.
  • To compare pain scores using the Visual Analog Scale (VAS) in patients receiving bupivacaine, bupivacaine with adrenaline, or no infiltration.

Main Methods:

  • A prospective, randomized, double-blind, controlled study.
  • Eighty-nine patients undergoing thyroidectomy were randomized into three groups: bupivacaine infiltration, bupivacaine with adrenaline infiltration, and control (no infiltration).
  • Pain was assessed using VAS at 2, 4, 6, 12, and 24 hours post-surgery.

Main Results:

  • No statistically significant differences in pain perception (VAS scores) were observed among the three groups at any measured time point (p=0.246).
  • Visual Analog Scale scores showed a significant decrease at 12 and 24 hours post-operation across all groups, suggesting natural pain reduction over time.
  • The addition of adrenaline to bupivacaine did not yield a significant difference in pain reduction compared to bupivacaine alone or the control group.

Conclusions:

  • Local wound infiltration with 0.5% bupivacaine does not appear to significantly decrease pain perception after thyroidectomy under general anesthesia.
  • Adding adrenaline to bupivacaine for local wound infiltration does not enhance its analgesic effect in the context of thyroidectomy.
  • Further research may be needed to explore alternative or multimodal approaches for optimizing postoperative pain management after thyroidectomy.