ABSTRACT
Superficial cervical nerve block may reduce post-thyroidectomy pain. The aim of this study was to evaluate the influence of BSCBs as pre-emptive analgesia on patient satisfaction post- thyroidectomy surgery. Fifty adult patients were randomly allocated to one of the two groups, to receive either 20 mL isotonic sodium chloride solution [Saline group] or 20 mL bupivacaine 0.25% [Bupivacaine group] as BSCBs before induction of general anesthesia. Thyroid surgery was performed according to a standardized procedure by the same surgeon. Patients were transferred to the PACU where they stayed for 2 h, then were transferred to the ward. Morphine was administered in PACU following a standardized protocol [1-2 mg repeated every 10 minutes until the pain was controlled] if the VAS score was >/= 40 mm. Postoperative pain: was assessed by visual analogue scale [VAS], with 100 being the worst pain and 0 being no pain, by a nurse trained in pain assessment when patient is fully awake and extubated [H0], before discharge from the PACU [H+2], and every 4 h until 24 h after the end of surgery. Was evaluated the day after surgery by the anaesthetist using a 5- point verbal score [0: poor; 1: moderate; 2 good; 3: very good; 4 excellent. Total amount of morphine used in PACU and after 24hours. All adverse effects were recorded. There were no significant statistical differences between both groups as regard demographic data, duration of anesthesia and duration of surgery. The main outcome variables were pain scores [VAS], the proportion of patients given morphine at PACU and 24-h after surgery as well as the amount of morphine required. The Bupivacaine group had a smaller proportion of patients given morphine [24% vs. 72%; P = 0.0016] and [40% vs. 84%] in PACU and 24 hour after surgery respectively. Patients given BSCBs had significantly lower VAS with excellent satisfaction. We conclude that bilateral superficial cervical plexus blocks significantly reduce pain intensity and Opioids requirement in the postoperative period after thyroid surgery with excellent patient satisfaction