Comparison of analgesic efficacy between bilateral superficial and combined (superficial and deep) cervical plexus block administered before thyroid surgery.
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.
Suh
Young-Jin
YJ
Department of General Surgery, Saint Vincent Hospital, The Catholic University of Korea, Suwon, Korea.
Kim
Yong Shin
YS
In
Jank Hyeok
JH
Joo
Jin Deok
JD
Jeon
Yeon-Soo
YS
Kim
Hyong-Keon
HK
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
D000577:Amides; D000779:Anesthetics, Local; D006993:Hypnotics and Sedatives; D010880:Piperidines; D000077212:Ropivacaine; D000077208:Remifentanil; D015742:Propofol