This study aims to compare the efficacy and safety of cervical erector spinae plane block vs. cervical plexus block in controlling acute postoperative pain after thyroidectomy.
Thyroidectomy is one of the most commonly performed surgeries in females worldwide, as thyroid disease predominantly affects females with a ratio of 4:1. Thyroid operations can cause mild to moderate incisional pain. It has also been reported that the morphine consumption on the first postoperative day is 90%. Cervical plexus block, either superficial or deep or combinations given bilaterally, could easily lead to an adequate block appropriate for thyroid surgery without any significant side effects. Erector spinae plane block (ESPB) is the new favorite among various fascial plane blocks. Local anesthetic drug is injected in the fascial plane superficial to the transverse process and deeper to the erector spinae muscle (ESM).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
40
Patients will receive bilateral ultrasound-guided cervical erector spinae plane block using 15 ml of bupivacaine 0.25% on each side.
Patients will receive bilateral ultrasound-guided superficial cervical block using 15 mL of 0.25% plain bupivacaine on each side of the neck.
Cairo University
Cairo, Egypt
Total morphine consumption
Rescue analgesia of morphine will be given as 3 mg bolus if the numeric rating scale (NRS) \> 3 to be repeated after 30 min if pain persists until the NRS \< 4.
Time frame: 48 hours postoperatively
Time to the 1st rescue analgesia
Time to the first request for the rescue analgesia (time from end of surgery to first dose of morphine administrated).
Time frame: 48 hours postoperatively
Intraoperative fentanyl consumption
Additional bolus doses of fentanyl 1 µg/kg will be given if the mean arterial blood pressure (MAP) or heart rate (HR) rises above 20% of baseline levels.
Time frame: Intraoperatively
Degree of pain
Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS) score. NRS (0 represents "no pain" while 10 represents "the worst pain imaginable"). NRS will be assessed at post-anesthesia care unit (PACU), 1, 2, 4, 6, 8, 12, 18, 24, 36 and 48 h postoperative.
Time frame: 48 hours postoperatively
Incidence of adverse events
Incidence of adverse events such as nausea, vomiting, hypotension, bradycardia, cough, bronchospasm, and sore throat will be recorded.
Time frame: 48 hours postoperatively
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