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Betancourt C, Sanabria A. Post-thyroidectomy bilateral cervical plexus block relieves pain: a systematic review. Eur Arch Otorhinolaryngol 2024; 281:3765-3778. [PMID: 38709322 DOI: 10.1007/s00405-024-08626-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 03/18/2024] [Indexed: 05/07/2024]
Abstract
PURPOSE To assess the effectiveness of bilateral superficial cervical plexus block (BSCPB) in treating post-thyroidectomy pain. METHODS MEDLINE, Embase, Google Scholar, LILACS, and the Cochrane Central Register of Controlled Trials, were extensively searched. The search period extended from 1968 until December 2022. Randomized controlled trials comparing BSCPB to placebo, no block in patients with thyroidectomy for benign or malignant thyroid disease were included. Outcomes were pain in the first 24 h after surgery. Analgesic rescue, period before the first rescue dosage, and 24-h opioid usage were secondary outcomes. The RoB 2 instrument was used to evaluate the risk of bias. RESULTS 34 of 354 studies were eligible. There were 2,519 patients. BSCPB reduced the intensity of pain postoperatively [SMD: - 1.17 (95% CI: - 1.54 to - 0.81)] and in the first 24 h [- 0.62 (95%: 0.91 to 0.33)]. A considerable delay for the first opioid dose, rescue analgesics, and postoperative opioid usage was also found. CONCLUSION BSCPB's 24-h analgesic efficacy minimizes the requirement for rescue analgesia, postoperative opioid intake, and rescue analgesia start time. The choice of anesthetic and different application methods might affect its effectiveness.
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Affiliation(s)
- Carlos Betancourt
- Head and Neck Service, Hospital Alma Mater, Medellín, Colombia
- CEXCA, Centro de Excelencia en Enfermedades de Cabeza y Cuello, Medellín, Colombia
| | - Alvaro Sanabria
- Head and Neck Service, Hospital Alma Mater, Medellín, Colombia.
- CEXCA, Centro de Excelencia en Enfermedades de Cabeza y Cuello, Medellín, Colombia.
- Department of Surgery, School of Medicine, Universidad de Antioquia, Cra. 51d #62-29, Medellín, Colombia.
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Ultrasound-guided bilateral superficial cervical plexus block enhances the quality of recovery of uremia patients with secondary hyperparathyroidism following parathyroidectomy: a randomized controlled trial. BMC Anesthesiol 2021; 21:228. [PMID: 34536993 PMCID: PMC8449502 DOI: 10.1186/s12871-021-01448-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 09/08/2021] [Indexed: 02/07/2023] Open
Abstract
Background Parathyroidectomy has been proposed as a method for reducing parathyroid hormone levels. We evaluated the effects of ultrasound-guided bilateral superficial cervical plexus block (BSCPB) on the quality of recovery of uremia patients with secondary hyperparathyroidism (SHPT) following parathyroidectomy. Methods Eighty-two uremia patients who underwent parathyroidectomy and exhibited SHPT were randomly allocated to the BSCPB group or the control group (CON group). The patients received ultrasound-guided BSCPB with 7.5 ml of ropivacaine 0.5% on each side (BSCPB group) or equal amount of 0.9% normal saline (CON group). The primary outcome of the Quality of Recovery-40(QoR-40) score was recorded on the day before surgery and postoperative day 1(POD1). Secondary outcomes including total consumption of remifentanil, time to first required rescue analgesia, number of patients requiring rescue analgesia, and total consumption of tramadol during the first 24 h after surgery were recorded. The occurrence of postoperative nausea or vomiting (PONV) and the visual analogue scale (VAS) scores were assessed and recorded. Results The scores on the pain and emotional state dimensions of the QoR-40 and the total QoR-40 score were higher in the BSCPB group than in the CON group on POD1 (P = 0.000). Compared with the CON group, the total consumption of remifentanil was significantly decreased in the BSCPB group (P = 0.000). The BSCPB group exhibited longer time to first required rescue analgesia (P = 0.018), fewer patients requiring rescue analgesia (P = 0.000), and lower postoperative total consumption of tramadol during the first 24 h after surgery (P = 0.000) than the CON group. The incidence of PONV was significantly lower in the BSCPB group than in the CON group (P = 0.013). The VAS scores in the BSCPB group were lower than those in the CON group at all time-points after surgery (P = 0.000). Conclusion Ultrasound-guided BSCPB with ropivacaine 0.5% can enhance the quality of recovery, postoperative analgesia, and reduce the incidence of PONV in uremia patients with SHPT following parathyroidectomy. Trial registration ChiCTR1900027185
. (Prospective registered). Initial registration date was 04/11/2019.
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Karakış A, Tapar H, Özsoy Z, Suren M, Dogru S, Karaman T, Karaman S, Sahin A, Kanadlı H. [Perioperative analgesic efficacy of bilateral superficial cervical plexus block in patients undergoing thyroidectomy: a randomized controlled trial]. Rev Bras Anestesiol 2019; 69:455-460. [PMID: 31627901 DOI: 10.1016/j.bjan.2019.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 06/14/2019] [Accepted: 06/29/2019] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION Bilateral superficial cervical plexus block (BSCPB) is a common method used for analgesia in thyroid surgery. We investigated the analgesic efficacy of bilateral superficial cervical plexus block in the intraoperative and postoperative periods. MATERIALS AND METHODS Patients (n = 46) undergoing thyroidectomy were randomly separated into the following 2 groups: the general anesthesia group (GA; n = 23) and the general anesthesia plus BSCPB group (GS; n = 23). The intraoperative analgesic requirement (remifentanil) visual analog scale (VAS) score at multiple time points during the postoperative period (after extubation, at 15 and 30 minutes and 1, 2, 6, 12, 24 and 48 hours post operation) were evaluated. Total tramadol and paracetamol consumption as well as the amount of ondansetron used was recorded. RESULTS The intraoperative remifentanil requirement was significantly lower in the GS Group than in the GA Group (p = 0.009). The postoperative pain scores were significantly lower in the GS Group than in the GA Group at 15 (p < 0.01) and 30 (p < 0.01) minutes and 1 (p < 0.01), 2 (p < 0.01), 6 (p < 0.01), 12 (p < 0.01) and 24 (p = 0.03) hours. The postoperative tramadol requirement was significantly lower in the GS Group than in the GA Group (p = 0.01). The number of patients that used ondansetron was significantly lower in the GS Group than in the GA Group (p = 0.004). CONCLUSION We concluded that BSCPB with 0.25% bupivacaine reduces the postoperative pain intensity and opioid dependency in thyroid surgery patients.
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Affiliation(s)
- Alkan Karakış
- Kilis State Hospital, Department of Anesthesiology and Reanimation, Kilis, Turquia.
| | - Hakan Tapar
- Gaziosmanpasa University, Medical Faculty, Department of Anesthesiology and Reanimation, Tokat, Turquia
| | - Zeki Özsoy
- Gaziosmanpasa University, Medical Faculty, Department of General Surgery, Tokat, Turquia
| | - Mustafa Suren
- Gaziosmanpasa University, Medical Faculty, Department of Anesthesiology and Reanimation, Tokat, Turquia
| | - Serkan Dogru
- Gaziosmanpasa University, Medical Faculty, Department of Anesthesiology and Reanimation, Tokat, Turquia
| | - Tuğba Karaman
- Gaziosmanpasa University, Medical Faculty, Department of Anesthesiology and Reanimation, Tokat, Turquia
| | - Serkan Karaman
- Gaziosmanpasa University, Medical Faculty, Department of Anesthesiology and Reanimation, Tokat, Turquia
| | - Aynur Sahin
- Gaziosmanpasa University, Medical Faculty, Department of Anesthesiology and Reanimation, Tokat, Turquia
| | - Hasan Kanadlı
- Kilis State Hospital, Department of Anesthesiology and Reanimation, Kilis, Turquia
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Karakış A, Tapar H, Özsoy Z, Suren M, Dogru S, Karaman T, Karaman S, Sahin A, Kanadlı H. Perioperative analgesic efficacy of bilateral superficial cervical plexus block in patients undergoing thyroidectomy: a randomized controlled trial. BRAZILIAN JOURNAL OF ANESTHESIOLOGY (ENGLISH EDITION) 2019. [PMID: 31627901 PMCID: PMC9391879 DOI: 10.1016/j.bjane.2019.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Alkan Karakış
- Kilis State Hospital, Department of Anesthesiology and Reanimation, Kilis, Turquia.
| | - Hakan Tapar
- Gaziosmanpasa University, Medical Faculty, Department of Anesthesiology and Reanimation, Tokat, Turquia
| | - Zeki Özsoy
- Gaziosmanpasa University, Medical Faculty, Department of General Surgery, Tokat, Turquia
| | - Mustafa Suren
- Gaziosmanpasa University, Medical Faculty, Department of Anesthesiology and Reanimation, Tokat, Turquia
| | - Serkan Dogru
- Gaziosmanpasa University, Medical Faculty, Department of Anesthesiology and Reanimation, Tokat, Turquia
| | - Tuğba Karaman
- Gaziosmanpasa University, Medical Faculty, Department of Anesthesiology and Reanimation, Tokat, Turquia
| | - Serkan Karaman
- Gaziosmanpasa University, Medical Faculty, Department of Anesthesiology and Reanimation, Tokat, Turquia
| | - Aynur Sahin
- Gaziosmanpasa University, Medical Faculty, Department of Anesthesiology and Reanimation, Tokat, Turquia
| | - Hasan Kanadlı
- Kilis State Hospital, Department of Anesthesiology and Reanimation, Kilis, Turquia
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Oh BY, Park YA, Koo HY, Yun SH, Kim HC, Lee WY, Cho J, Sim WS, Cho YB. Analgesic efficacy of ropivacaine wound infusion after laparoscopic colorectal surgery. Ann Surg Treat Res 2016; 91:202-206. [PMID: 27757398 PMCID: PMC5064231 DOI: 10.4174/astr.2016.91.4.202] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 07/15/2016] [Accepted: 08/03/2016] [Indexed: 12/26/2022] Open
Abstract
Purpose Local anesthetic wound infusion has been previously investigated in postoperative pain management. However, a limited number of studies have evaluated its use in laparoscopic colorectal surgery. This study aims to evaluate whether ropivacaine wound infusion is effective for postoperative pain management after laparoscopic surgery in patients with colorectal cancer. Methods This prospective study included 184 patients who underwent laparoscopic surgery for colorectal cancer between July 2012 and June 2013. The patients were grouped as the combined group (intravenous patient-controlled analgesia [IV-PCA] plus continuous wound infusion with ropivacaine, n = 92) and the PCA group (IV-PCA only, n = 92). Efficacy and safety were assessed in terms of numeric rating scale (NRS) pain score, opioid consumption, postoperative recovery, and complications. Results The total quantity of PCA fentanyl was significantly less in the combined group than in the PCA group (P < 0.001). The NRS score of the combined group was not higher than in the PCA group, despite less opioid consumption. There were no differences between groups for postoperative recovery and most complications, including wound complications. However, the rate of nausea and vomiting was significantly lower in the combined group (P = 0.022). Conclusion Ropivacaine wound infusion significantly reduced postoperative opioid requirements and the rate of nausea/vomiting. This study showed clinical efficacy of ropivacaine wound infusion for postoperative pain control in colorectal cancer patients undergoing laparoscopic surgery.
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Affiliation(s)
- Bo Young Oh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon Ah Park
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye Young Koo
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seong Hyeon Yun
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Cheol Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Woo Yong Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Juhee Cho
- Department of Health Sciences and Technology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Woo Seog Sim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yong Beom Cho
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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