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Ultrasound-guided bilateral superficial cervical plexus blocks enhance the quality of recovery in patients undergoing thyroid cancer surgery: A randomized controlled trial.

AbstractSTUDY OBJECTIVE:
Regional anesthesia can improve postoperative analgesia and enhance the quality of recovery (QoR) after surgery. This trial evaluates the effects of ultrasound-guided bilateral superficial cervical plexus block (SCPB) on QoR in patients undergoing thyroid cancer surgery.
DESIGN:
Prospective, randomized, double-blinded, placebo-controlled trial.
SETTING:
Operating room.
PATIENTS:
Seventy-four ASA I-II female patients scheduled for thyroid cancer surgery were included to the study.
INTERVENTIONS:
Patients were randomly allocated to receive pre-operative ultrasound-guided bilateral SCPB with 10 ml of ropivacaine 0.5% or normal saline on each side.
MEASUREMENTS:
The primary endpoint was the quality of recovery, which was assessed using the 15-item quality of recovery questionnaire (QoR-15). Secondary endpoints were acute postoperative pain, time to first rescue analgesia, the number of patients requiring rescue analgesia, length of post-anesthesia care unit (PACU) stay, the incidence of postoperative nausea or vomiting (PONV) and dizziness, and patient satisfaction.
MAIN RESULTS:
The global QoR-15 score at 24 h postoperatively was significantly higher in the SCPB group (Median [IQR], 118 [115-120]) than the control group (110 [106-112]) with a median difference of 8 (95% CI: 6 to 10, P < .001). Compared with the control group, pre-operative ultrasound-guided bilateral SCPB reduced postoperative pain up to 24 h and the incidence of PONV, as well as the length of PACU stay. Additionally, the patient satisfaction scores were improved in the SCPB group (P = .024).
CONCLUSION:
Pre-operative ultrasound-guided bilateral SCPB with ropivacaine enhances the quality of recovery, postoperative analgesia and patient satisfaction, alleviates the incidence of PONV, and accelerates the PACU discharge following thyroid cancer surgery.
AuthorsYusheng Yao, Cailing Lin, Qiaolan He, Hongxin Gao, Lufen Jin, Xiaochun Zheng
JournalJournal of clinical anesthesia (J Clin Anesth) Vol. 61 Pg. 109651 (May 2020) ISSN: 1873-4529 [Electronic] United States
PMID31761416 (Publication Type: Journal Article, Randomized Controlled Trial)
CopyrightCopyright © 2019 Elsevier Inc. All rights reserved.
Chemical References
  • Anesthetics, Local
Topics
  • Anesthetics, Local
  • Cervical Plexus Block (adverse effects)
  • Double-Blind Method
  • Female
  • Humans
  • Nerve Block (adverse effects)
  • Pain Measurement
  • Pain, Postoperative (epidemiology, etiology, prevention & control)
  • Prospective Studies
  • Thyroid Neoplasms (surgery)
  • Ultrasonography, Interventional

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