title: Analgesic efficacy of bilateral superficial and deep cervical plexus block in patients with secondary hyperparathyroidism due to chronic renal failure.
abstract: OBJECTIVE
  Secondary hyperparathyroidism (SHPT) develops in patients with chronic renal failure. This study aimed to compare analgesic efficacy in SHPT patients who undergo subtotal parathyroidectomy after superficial versus deep cervical plexus block.
  
  
  METHODS
  Sixty chronic renal failure patients with SPHT scheduled for subtotal parathyroidectomy were randomized to receive general anesthesia (group GA), general anesthesia plus bilateral superficial and deep cervical plexus block (group BD), or general anesthesia plus bilateral superficial cervical plexus block (group BS) (n = 20). Bilateral superficial cervical plexus block or combined superficial and deep cervical plexus block with 0.5% ropivacaine was administered. Postoperative pain was assessed using visual analogue scale (VAS).
  
  
  RESULTS
  VAS score at 1 hour, 4 hours, and 8 hours after operation was 3.71 ± 0.60, 2.72 ± 0.54, 2.17 ± 0.75 in BS group; 4.00 ± 0.28, 2.89 ± 0.21, and 2.46 ± 1.01 in BD group, significantly lower than in GA group (6.50 ± 0.50, 5.02 ± 0.54, and 4.86 ± 0.51, respectively). The dosage of tramadol was 109.0 ± 35.2 mg in BS group and 93.0 ± 24.52 mg in BD group, significantly lower than in GA group (300.0 ± 27.13 mg). The incidence of complications in GA group (90%) was significantly higher than in BS group (30%) and BD group (15%). Serum glucose and norepinephrine levels were significantly higher at 1 hour, 4 hours, and 8 hours after operation, but returned to baseline levels at 24 hours after operation.
  
  
  CONCLUSIONS
  Superficial cervical plexus block or combined superficial and deep cervical plexus block effectively reduces postoperative pain, stress response, and complications in SHPT patients who undergo subtotal parathyroidectomy.
authors.affiliation: Department of Anesthesiology, The Second Clinical Medical College of JiNan University, Shenzhen People's Hospital, Shenzhen, China.
authors.forename: Yinglan
authors.initials: Y
authors.lastname: Su
authors.affiliation: Department of Anesthesiology, The Second Clinical Medical College of JiNan University, Shenzhen People's Hospital, Shenzhen, China.
authors.forename: Zhongjun
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Anesthesiology, The Second Clinical Medical College of JiNan University, Shenzhen People's Hospital, Shenzhen, China.
authors.forename: Qiuli
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Anesthesiology, The Second Clinical Medical College of JiNan University, Shenzhen People's Hospital, Shenzhen, China.
authors.forename: Yaoxian
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Anesthesiology, The Second Clinical Medical College of JiNan University, Shenzhen People's Hospital, Shenzhen, China.
authors.forename: Zhanli
authors.initials: Z
authors.lastname: Liu
keywords: Cervical plexus; Chronic kidney failure; Parathyroidectomy; Secondary hyperparathyroidism