Role of superficial cervical plexus block with lignocaine and dexamethasone following modified radical mastoidectomy: A randomised controlled trial

Aims and Objectives The study aimed to compare the worst pain levels following superficial cervical plexus block (SCPB) with lignocaine and perineural dexamethasone versus no block using the PAIN OUT patient outcome questionnaire. Material and Methods This randomised, placebo-controlled trial included 46 patients, 18–70 years of age, of the American Society of Anesthesiologists (ASA) physical status I/II scheduled for mastoidectomy. The postoperative maximum pain intensity scores using the PAIN OUT patient outcome questionnaire were considered as the primary outcome. The patients received interventions as per group allocation. In group block (n = 23), an ultrasound-guided (USG) SCPB was administered using 5 ml of 2% lignocaine with 4 mg dexamethasone. In group control (n = 23), no block was performed, and only dressing was done. All patients received intravenous (IV) paracetamol 1 g every 6 h. In case any patient-reported pain, IV diclofenac was administered. Results During the study period of 24 hours, patients in group block experienced lower worst pain as compared to group control(p-value = 0.001). Similarly, the visual analogue scale score on movement was lower in group block at the following intervals: 15 min (p-value = 0.02), at 1 hour (p-value = 0.007), at 4 hours (p = 0.03), and 12 hours (p-value = 0.04) following surgery. Rescue analgesia was lower in group block versus group control (p-value < 0.01). Conclusion Postoperative SCPB with lignocaine and perineural dexamethasone provided a superior worst pain score during 24 hours using the PAIN OUT patient outcome questionnaire following modified radical mastoidectomy.