STUDY OF ANALGESIC EFFECT OF BILATERAL SUPERFICIAL CERVICAL PLEXUS BLOCK ADMINISTERED BEFORE THYROID SURGERY UNDER GENERAL ANAESTHESIA AS COMPARED TO GENERAL ANAESTHESIA ALONE

Abstract

Background: Postoperative pain management is crucial in patients undergoing
thyroid surgery. This study aimed to evaluate the analgesic efficacy of bilateral
superficial cervical plexus block (BSCPB) with bupivacaine and clonidine in
combination with general anesthesia (GA) compared to GA alone or GA with
BSCPB using bupivacaine only.
Methods: In this prospective, randomized study, 144 patients undergoing thyroid
surgery were allocated into three groups: GA+BSCPB with bupivacaine and
clonidine, GA+BSCPB with bupivacaine only, and GA alone. Postoperative pain
scores, time to first analgesic administration, analgesic requirements, and
perioperative hemodynamic parameters were assessed.
Results: The mean Visual Analog Scale (VAS) scores at 2 and 6 hours
postoperatively were significantly lower in the GA+BSCPB with bupivacaine and
clonidine group (2.48 ± 0.68 and 1.98 ± 0.36, respectively) compared to the
GA+BSCPB with bupivacaine only (4.79 ± 0.68 and 4.25 ± 0.78, respectively) and
GA alone groups (7.23 ± 0.42 and 6.37 ± 0.48, respectively) (p<0.01). The mean
time to first analgesic administration was significantly longer, and the mean dose of
diclofenac received at 6 hours was significantly lower in the GA+BSCPB with
bupivacaine and clonidine group compared to the other two groups (p<0.01). BSCPB
with bupivacaine and clonidine also resulted in significantly lower perioperative
pulse rate and blood pressure (p<0.0001).
Conclusion: BSCPB with bupivacaine and clonidine in combination with GA
provides superior postoperative analgesia and perioperative hemodynamic stability
compared to GA alone or GA with BSCPB using bupivacaine only in patients
undergoing thyroid surgery.