A Randomized Double-Blind Placebo-Controlled Clinical Trial To Assess The Efficacy Of Dexamethasone To Provide Postoperative Analgesia After Cervical Plexus Block In Patients Undergoing Elective Thyroid Surgery

ABSTRACT

In an attempt to improve the patient comfort after thyroidectomy, various methods of pain-relief have been tried to prolong the duration and to improve the quality of postoperative analgesia. Cervical plexus block using steroids like dexamethasone, administered as an adjuvant along with local anaesthetic agents, could be of particular interest. Methods: Fifty patients undergoing elective thyroidectomy were randomly assigned to one of the following groups containing twenty five patients each. Group D patients received 8 mg (2 ml) of dexamethasone added to 13 ml of 0.25% levobupivacaine as cervical plexus block (total volume 15 ml). Group L patients received 13 ml of 0.25% levobupivacaine and 2 ml of isotonic saline (15 ml in total) as cervical plexus block. Analgesic effect was evaluated by measuring pain intensity (VAS score) and duration of analgesia. Results: A longer delay was observed for first requirement of supplementary analgesic in group D (572.24±68.42 minutes ) compared to group L (402.46±52.34 minutes). Total consumption of diclofenac sodium in first 24 hours in postoperative period was significantly less in group D. No significant side effects were noted. Conclusion: Dexamethasone, used as adjuvant to levobupivacaine for cervical plexus block in patients undergoing thyroidectomy, improve the quality and prolong the duration of post operative analgesia.