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Updated: May 12, 2026

Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy
Published on: October 24, 2025
Enhanced Analgesia and Reduced Opioid Use with Dexmedetomidine-Ropivacaine for Superficial Cervical Plexus Block in
Sucheta Bagri1, Rajan B Godwin1, Ashish Gupta1
1Department of Anesthesiology, Netaji Subhash Chandra Bose Medical College and Hospital, Jabalpur, Madhya Pradesh, India.
Introduction:
There are concerns about addiction to opioids due to excessive prescription after surgery.
Objective:
We compared the impact of dexmedetomidine as an additive to ropivacaine for bilateral cervical plexus block to that of ropivacaine alone for postoperative analgesia in patients undergoing thyroidectomy.
Methods:
A total of 60 patients were randomized in 2 groups: those submitted to bilateral superficial cervical plexus block (BSCPB) using 0.375% ropivacaine (group BSCPB-R, the control group) and those submitted to BSCPB using 0.375% ropivacaine with 1mcg/kg of dexmedetomidine (group BSCPB-RD, the study group). The resultant postoperative analgesia was compared by the morphine milligram equivalents (MMEs) required by each patient.
Results:
Only 3 (10%) patients in the BSCPB-R group and 2 (6.6%) patients in the BSCPB-RD group required opioid analgesia. The mean total rescue opioid required in the first 24 hours was significantly higher in group BSCPB-R compared to group BSCPB-RD (20 ± 8.14 versus 8 ± 2.85 MME respectively; p = 0.0001). Similarly, the mean total MMEs required during the first 5 days after surgery was of 38 ± 16.4 for group BSCPB-R and 18 ± 8 for group BSCPB-RD ( p = 0.0001).
Conclusion:
The combination of dexmedetomidine and ropivacaine in the BSCPB protocol results in a lower requirement of opioids for pain in the postoperative period, and very few (if any) patients undergoing thyroid surgery require postoperative opioids with this strategy.
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