Background: More than 230 million people undergo surgery each year worldwide, and the number is increasing annually. Surgery causes commonly postoperative pain that should be alleviated as soon as possible to reduce suffering, and to promote the healing process and rehabilitation, and to prevent complications. Pain after thyroid surgery is regarded as being of moderate intensity and short duration. However, during the first 24 h after surgery, some patients require opioid and non-opioid analgesics.
Objectives: The aim of this work was to compare the effect of superficial cervical block combined with general anesthesia, intravenous morphine in patients undergo thyroidectomy operation as regard as the heamodynamics intraoperative and post-operative analgesia.
Patients and Methods: After obtaining the approval of the Al-Azhar University Ethical Committee, eighty patients of American Society of Anethesiologists (ASA) physical status I or II, scheduled for thyroidectomy operation under general anesthesia were enrolled in this randomized, prospective, clinical trial study. Information about the study were given comprehensively both orally and in written forms to the patients. All patients gave their written informed consents prior to their inclusion in the study. The study was carried out in Al-Azhar University Hospitals (AL- Hussein &Sayed Galal Hospitals). Eighty patients were randomly divided into two equal groups: Group {A} received a bilateral superficial cervical block (15ml per side) with bupivacaine 0.25% after induction of general anesthesia, and Group {B} recived morphine (0.1 mg\ kg body weight) 15 minutes before induction of general anesthesia.
Results: The results of the present study revealed that mean arterial pressure (MAP) and heart rate (HR) were significantly lower in Group (A) compared with group (B). Pethidine requirements during the first 24 h after thyroidectomy were significantly reduced in Group (A) compared with Group (B). At post-operative care unit (PACU) admission, pain scores were significantly lower in Group (A) than in Group (B). Pain scores decreased in the two groups during the 24 h after surgery. Thirty-four patients (42.2%) developed post-operative nausea and vomiting (PONV) in the post-operative care unit (PACU), 8 patients in Group (A), 26 patients in Group (B).
Conclusion: Bilateral superficial cervical plexus block (BSCPB) was an effective technique to reduce analgesic requirements during and after thyroid surgery and improved the anethetic outcome more than intravenous injection of morphine.