Evaluation Of The Analgesic Effect Of Bilateral Superficial Cervical Plexus Block For Thyroid Surgery

Objective: Bilateral superficial cervical plexus block combined with general anesthesia could relieve the incision pain in patients undergoing thyroid surgery.However,most of these patients have the complaints of the throat discomfort.This randomized clinical trial was performed to investigate the analgesic effect of the sore throat and the incision pain of bilateral superficial cervical plexus block combined with general anesthesia for thyroid surgery.Methods: 80 patients scheduled for thyroid surgery were divided into two groups.They were randomly assigned to receive a bilateral superficial cervical plexus block(10ml per side)with ropivacaine 0.5%(group R;n=40)or isotonic saline(group S;n=40)after induction of general anesthesia.Postoperative pain was assessed by visual analog scale(VAS)after 2h(PO2h),6h(PO6h),24h(PO24h)and 48h(PO48h)of the surgery.VAS was assessed at two phases: sore throat(at rest and swallowing)and incision pain(at rest and neck movements).Total use of intraoperative fentanyl and numbers of patients needing postoperative analgesics were noted.Postoperative nausea and vomiting for 24 h and surgery site infections for 1 week were also assessed.Results: The pain after thyroid surgery occurs between 6h and 24 h mostly.And after24 h,the VAS score has significant reduction.The VAS scores for incision pain on neck movement in group R were remarkably lower than those in the group S after6h(PO6h)and 24h(PO24h)of the surgery(P=0.007).The VAS scores for sore throat(at rest and swallowing)and incision pain(at rest and neck movements)in other time period were similar and had no statistical significance;There was no differenceon the total use of intraoperative fentanyl(P=0.963);Furthermore,the usage rate of postoperative analgesics,the incidences of postoperative nausea and vomiting for24 h and surgery site infections(SSI)for 1 week in the two groups were similar and had no statistical significance(P>0.05).Conclusion: Bilateral superficial cervical plexus block combined with general anesthesia can relieve the incision movement pain between 6h and 24 h after the thyroid surgery,but can not relieve the sore throat after the thyroid surgery;The requirement of postoperative analgesic can not be decreased by using bilateral superficial cervical plexus block;The incidence of postoperative nausea and vomiting also can not be reduced through this way.