In the domain of endocrine gland surgery, thyroidectomy is the most common procedure. Patients report moderate to severe discomfort postoperatively, which is induced by a variety of mechanisms, the most common of which are cervical incision and surgical maneuvers. The other two causes are endotracheal intubation and neck overextension. Incisional pain, odynophagia, dysphagia, neck and shoulder pain have all been reported as sources of discomfort.However, it seems that this discomfort has a time limit, with a considerable decrease in pain scores that will last 24 to 36 hours. Pain is felt more profoundly within the first few hours after surgery, peaking at 6 hours, with patients requesting further analgesic medication. Surgical wound infiltration can inhibit this procedure by preventing the alginate signal from reaching the incision site's receptors. According to the multimodal analgesia trends, magnesium sulfate can be added to the ropivacaine solution. Magnesium acts as an NMDA (N-methyl-D-aspartate) receptor antagonist, inhibiting cerebral sensitization to peripheral pain stimuli while reducing pre-existing hyperalgesia. It becomes evident that this combination could contribute to attain the maximum analgesic efficacy. So, if any superiority of ropivacaine plus magnesium sulphate over ropivacaine could be demonstrated this would be very helpful in providing sufficient analgesic effects with a low incidence of adverse effects, while enhancing the option of one day surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
DOUBLE
Enrollment
68
12 ml N/S 0.9% at the end of surgery
12 ml solution of 100mg ropivacaine at the end of surgery
12 ml solution of 100mg ropivacaine plus magnesium sulphate 10mg/kg at the end of surgery
Aristotle University
Thessaloniki, Other, Greece
Efficacy of Ropivacaine Plus Magnesium Sulphate Infiltration vs Ropivacaine
Calculation of the total post-operative analgesic doses administered, converted to effective mg of morphine.
Time frame: 24 postoperative hours
Incisional Pain
Incisional Pain will be measured by Visual Analogue Scale (VAS) pain questionnaire
Time frame: 30 minutes ,1 hour, 2 hours, 4 hours, 6 hours, 12 hours, 24 hours
Subjective measurements 1
Alterations in cortisol in μg/dl
Time frame: 30 minutes before the infiltration, 6 hours and 24 hours postoperatively
Subjective measurements 2
Alterations in Tumor Necrosis Factor a (TNF-a) in pg/ml
Time frame: 30 minutes before the infiltration, 6 hours and 24 hours postoperatively
Subjective measurements 3
Alterations in Interleukin 6 (IL-6) in pg/ml
Time frame: 30 minutes before the infiltration, 6 hours and 24 hours postoperatively
Complications
Adverse effects of the infiltrated agents
Time frame: 24 hours, 7 days
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