Randomized controlled trial comparing bilateral superficial cervical plexus block and local wound infiltration for...

Area of Science:

• Anesthesiology and Pain Management
• Surgical Outcomes Research

Background:

• Effective post-operative pain management is crucial for patients undergoing thyroid surgery.
• Local wound infiltration (LWI) and bilateral superficial cervical plexus block (BSCPB) are common analgesic techniques.
• Previous comparisons of LWI and BSCPB for thyroid surgery have yielded inconsistent results.

Purpose of the Study:

• To compare the efficacy of BSCPB versus LWI in reducing post-operative pain.
• To evaluate and compare opioid requirements within the first 24 hours after thyroid surgery.

Main Methods:

• A prospective, double-blinded randomized controlled trial was conducted.
• Seventy patients undergoing thyroid surgery were randomized to receive either BSCPB or LWI using 0.50% ropivacaine.
• Post-operative pain was assessed using the visual analog scale (VAS) at 4, 12, 16, and 24 hours; rescue analgesia with tramadol was administered as needed.

Main Results:

• No statistically significant difference in VAS pain scores was observed between the BSCPB and LWI groups at any time point (4, 12, 16, 24 hours).
• The time to the first rescue dose of tramadol was also comparable between the two groups.
• One patient in the BSCPB group experienced transient upper limb weakness, which resolved within 12 hours.

Conclusions:

• Local wound infiltration (LWI) is a simple, safe, and cost-effective method for post-thyroidectomy pain management.
• Bilateral superficial cervical plexus block (BSCPB) provides comparable analgesia to LWI but carries risks of regional block-related complications.