“ANALGESIC EFFICACY OF BILATERAL SUPERFICIAL CERVICAL PLEXUS BLOCK ADMINISTERED BEFORE THYROID SURGERY UNDER GENERAL ANAESTHESIA”

Abstract

Introduction:

Pre-emptive analgesia aims to prevent pain potentiation by administering analgesics before the onset of noxious stimuli. Acute postoperative pain, especially after thyroid surgery, is associated with altered synaptic functions and nociceptive processing. The use of preoperative local anaesthetic blocks, such as Bilateral Superficial Cervical Plexus Block (BSCPB), has shown to reduce postoperative pain, but no standard protocol is widely accepted. This study aims to assess the analgesic effectiveness of BSCPB with ropivacaine versus ropivacaine plus clonidine for thyroid surgery under general anaesthesia.

Methods:

Sixty patients undergoing thyroid surgery were randomly assigned to two groups: Group R (ropivacaine) and Group RC (ropivacaine plus clonidine). BSCPB was performed using a three-point technique, and postoperative pain was evaluated using the Visual Analogue Scale (VAS) at PACU and every 4 hours for the first 24 hours. Hemodynamic parameters, intraoperative analgesic requirements, and postoperative analgesic needs were recorded. Statistical analysis was performed using the Chi-square test and Student's t-test.

Results 

At baseline, no significant differences in hemodynamic parameters were observed between the two groups. However, during induction and intubation, significant differences in systolic blood pressure (SBP), mean arterial pressure (MAP), and heart rate (HR) were noted between the two groups. The duration of analgesia was significantly longer in Group RC, with a reduced requirement for postoperative opioids. VAS pain scores were significantly lower in Group RC compared to Group R.

Conclusion:

Bilateral Superficial Cervical Plexus Block with ropivacaine plus clonidine significantly improves postoperative analgesia and reduces opioid consumption in patients undergoing thyroid surgery. The addition of clonidine enhances the duration of analgesia and reduces intraoperative analgesic requirements, suggesting its potential as an effective and safe method for managing postoperative pain in this surgical population.