The Efficacy of Bilateral Superficial Cervical Plexus Block under Ultrasound Guidance for Pain and hemodynamic Control after thyroid surgery

Background: thyroid surgery can cause hemodynamic instability and postoperative pain. Regular general anesthesia and analgesia provide adequate effect for post operative pain control. Bilateral superficial cervical plexus block (BSCPB) provides an adjuvant technique to facilitate this approach, but there is great evidential heterogeneity in previous studies. Aims: to evaluate the efficacy of BSCPB under ultrasound guidance for pain and hemodynamic control after thyroid surgery. Patients and Methods: This is a prospective interventional study including 60 consecutive patients scheduled for elective thyroidectomy under general anesthesia. Patients were randomly assigned in to two equal groups each with 30 patients: block and non-block group. In block group, 5 ml of 0.375% bupivacaine was bilaterally injected into the subcutaneous space under ultrasound guidance, while non-block group had a routine anesthesia without such intervention. Results: During the zero min, 30 min and 1 hr. post recovery, block group showed lower mean SBP than non-block group with highly significant differences (p<0.001). Furthermore, block group demonstrated lower mean DBP during 30 min and 1 hr. post recovery than non-block group with highly significant differences (p<0.01). The remarkable differences between the two group in heart rate (HRE) started at zero hr. through 30 min, 1 hr. until 2 hr. post recovery in which the block group displayed lower mean HR with highly significant differences (p<0.001). From zero hr. until the last time point, block group showed lower mean pain score than non-block group with highly significant differences (P<0.001). Conclusions: Bilateral superficial cervical plexus block is feasible, safe, and effective for improving outcomes in patients undergoing thyroidectomy in terms of reducing pain, the systemic analgesic requirements following thyroid surgery and stabilizing of hemodynamic parameters.