Bilateral Cervical Plexus Block for Postoperative Pain After Thyroidectomy

Overview

Patients undergoing thyroidectomy frequently experience moderate postoperative pain that may require opioid analgesics. Opioid use is associated with adverse effects such as nausea, vomiting, respiratory depression, and delayed recovery. Ultrasound-guided regional anesthesia techniques may provide effective postoperative analgesia while reducing opioid consumption. The aim of this prospective randomized study was to evaluate the analgesic efficacy of ultrasound-guided bilateral superficial cervical plexus block (BSCPB) in patients undergoing thyroidectomy under general anesthesia. Patients were divided into two groups: a block group receiving BSCPB with 0.5% bupivacaine and a control group receiving general anesthesia alone. Postoperative pain scores, opioid consumption, intraoperative analgesic requirements, and postoperative complications were compared between the groups.

Postoperative pain is a common clinical problem following thyroidectomy and may negatively affect patient comfort, recovery, and overall surgical outcomes. Moderate postoperative pain is frequently observed after thyroid surgery, and inadequate pain control may lead to delayed mobilization, increased opioid consumption, and higher incidence of opioid-related adverse effects such as nausea, vomiting, respiratory depression, and sedation. Regional anesthesia techniques have increasingly been used as part of multimodal analgesia strategies to improve postoperative pain control while reducing opioid requirements. The bilateral superficial cervical plexus block (BSCPB) is a regional anesthesia technique that can provide effective analgesia for surgical procedures involving the neck, including thyroidectomy, parathyroid surgery, and cervical lymph node excisions. When performed under ultrasound guidance, BSCPB allows accurate identification of anatomical structures and precise local anesthetic administration, which may improve block success and reduce potential complications. The aim of this prospective study was to evaluate the analgesic efficacy of ultrasound-guided bilateral superficial cervical plexus block in patients undergoing thyroidectomy under general anesthesia. A total of 40 patients aged between 18 and 65 years with American Society of Anesthesiologists (ASA) physical status I-III scheduled for elective thyroidectomy were included in the study. Patients were divided into two groups. In the block group (Group B), patients received ultrasound-guided bilateral superficial cervical plexus block using 10 ml of 0.5% bupivacaine on each side prior to surgery in addition to general anesthesia. In the control group (Group K), patients underwent thyroidectomy under general anesthesia without cervical plexus block. Demographic characteristics, intraoperative hemodynamic parameters, anesthetic drug consumption, and intraoperative complications were recorded. Postoperative pain intensity was assessed using the Visual Analog Scale (VAS) and Numeric Rating Scale (NRS) at 0, 2, 6, 12, and 24 hours after surgery. Postoperative tramadol consumption within the first 24 hours was also recorded. Additionally, postoperative complications such as nausea, vomiting, and pruritus were evaluated. The primary objective of the study was to compare postoperative pain scores between the two groups. Secondary outcomes included intraoperative remifentanil consumption, postoperative tramadol consumption, hemodynamic parameters, and postoperative complications. The findings of this study aim to determine whether ultrasound-guided bilateral superficial cervical plexus block provides improved postoperative analgesia and reduces opioid requirements in patients undergoing thyroidectomy.