The goal of this study is to assess the efficacy of continuous local anesthetic wound infusion to improve quality of recovery following ablative surgery and neck dissection.
Bilateral cervical plexus catheters are convenient and safe to place under the direct vision of the surgeons during ablative and neck dissection. The investigators hypothesize that continuous local anesthetic wound infusion to block bilateral cervical plexus will improve quality of recovery following ablative surgery and neck dissection. The primary endpoint is the quality of recovery, which will be assessed using the 15-item quality of recovery questionnaire (QoR-15). Secondary endpoints include numeric pain scale, number and proportion of patients on salvage analgesics, Incidence of phrenic nerve block, Incidence of recurrent laryngeal nerve block, length of post-anesthesia care unit (PACU) stay, length of post-operative hospital stay.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
80
Prior to the end of neck dissection and any additional procedures, the bilateral catheter will be placed adjacent to the cervical plexus underneath the internal jugular vein, left in place for 24 hours and removed in a similar way to the Redon drainage by the surgeon. The CWI block will start immediately at a speed of 4ml/h containing 0.5% lidocaine hydrochloride + 1:400000 adrenaline.
Prior to the end of neck dissection and any additional procedures, the bilateral catheter will be placed adjacent to the cervical plexus underneath the internal jugular vein, left in place for 72 hours and removed in a similar way to the Redon drainage by the surgeon. The CWI placebo will start immediately at a speed of 4ml/h containing 0.9% normal saline + 1:400000 adrenaline.
Quality of Recovery
The primary outcome will be the 15-item quality of recovery questionnaire (QoR-15).
Time frame: At 24 hours after surgery
Postoperative salvage analgesics
Patients will be asked to complete a daily diary for 72 hours that records their daily postoperative salvage analgesics.
Time frame: Up to 72 hours after surgery
Phrenic nerve block
Patients will be asked to complete a daily diary for 72 hours that records their daily dyspnea.
Time frame: Up to 72 hours after surgery
Numeric rating scale (NRS) for pain
Patients will be asked to complete a daily diary for 72 hours that records the numeric pain rating scale composed of 0 (no pain at all) to 10 (worst imaginable pain).
Time frame: Up to 72 hours after surgery
Recurrent laryngeal nerve block
Patients will be asked to complete a daily diary for 72 hours that records their daily hoarseness.
Time frame: Up to 72 hours after surgery
Quality of Recovery
The primary outcome will be the 15-item quality of recovery questionnaire (QoR-15).
Time frame: Up to 72 hours after surgery
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