title: Comparison of analgesic efficacy between bilateral superficial and combined (superficial and deep) cervical plexus block administered before thyroid surgery.
abstract: OBJECTIVE
  To evaluate the analgesic efficacy of bilateral superficial cervical plexus block and combined superficial and deep cervical plexus block for incision pain, headache and posterior neck pain after thyroidectomy.
  
  
  METHODS
  Ninety patients were divided into a control group (group C, n = 30), a bilateral superficial cervical plexus group (group S, n = 30) and a bilateral combined superficial and deep cervical plexus block group (group CO, n = 30). Before general anaesthesia, we performed bilateral superficial cervical plexus block (18 ml) and combined superficial (14 ml) and deep (4 ml) cervical plexus block with 0.25% bupivacaine. Anaesthesia was maintained with propofol-remifentanil-N2O-O2.
  
  
  RESULTS
  The average concentration of remifentanil was significantly reduced in group S compared with group C and group CO (1.1 +/- 0.3, 1.8 +/- 0.4, 1.8 +/- 0.7 ng ml, respectively; P < 0.05). The incision pain at rest and on swallowing were significantly reduced at 0, 2 and 4 h in group S compared with group C (P < 0.05). Headache showed a tendency to be reduced in group S and group CO, but the posterior neck pain was not different among the three groups. After surgery, the opioid and nonopioid requirement was significantly reduced in group S (P < 0.05). There were fewer side effects and greater patients' satisfaction in group S.
  
  
  CONCLUSIONS
  Superficial cervical plexus block is a more effective technique than combined superficial and deep cervical plexus block to reduce the pain during and immediately after thyroidectomy.
authors: Department of General Surgery, Saint Vincent Hospital, The Catholic University of Korea, Suwon, Korea.
authors: Young-Jin
authors: YJ
authors: Suh
authors: Yong Shin
authors: YS
authors: Kim
authors: Jank Hyeok
authors: JH
authors: In
authors: Jin Deok
authors: JD
authors: Joo
authors: Yeon-Soo
authors: YS
authors: Jeon
authors: Hyong-Keon
authors: HK
authors: Kim
mesh_terms: D000577:Amides / Q000627:therapeutic use; D000768:Anesthesia, General / Q000379:methods*; D000779:Anesthetics, Local / Q000627:therapeutic use; D002572:Cervical Plexus / Q000033:anatomy & histology; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control*; D010880:Piperidines; D011300:Preoperative Care / Q000379:methods; D015742:Propofol; D000077208:Remifentanil; D000077212:Ropivacaine; D013965:Thyroidectomy; D016896:Treatment Outcome
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D006993:Hypnotics and Sedatives; D010880:Piperidines; D000077212:Ropivacaine; D000077208:Remifentanil; D015742:Propofol