Comparative Study Between Bilateral Superficial Cervical Plexus Block Alone and When Combined with Bilateral Greater Occipital Nerve Block For Post-Thyroidectomy Analgesia
Author(s): ,
Alfkey, R.
Faculty Of Medicine- Al Azhar University, General Surgery, Cairo, Egypt
Eldegwy, M.*
Faculty Of Medicine- Al Azhar University, Anesthesia- ICU- And Pain Management, Cairo, Egypt
ESRA Academy. Eldegwy M. Sep 13, 2017; 190998; 549 Topic: Acute Postoperative Pain - Postoperative & Perioperative Analgesia
Prof. Magdy Eldegwy
Prof. Magdy Eldegwy
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Background and Aims:

This prospective study compared the post-operative analgesic efficacy of ultrasound guided bilateral superficial cervical plexus bloc(BSCPB)alone and  with combination with bilateral greater occipital nerve block(BGONB)in patients undergoing thyroidectomy


63 adult patients undergoing thyroid surgery are enrolled and randomized into three groups(21patients each).Group1(n=21):patients received bilateral(BSCP) only,Group 2 (n=21):patients receiving bilateral (BSCP) and (GONB), Group 3 (n=21):  patients received no block. Levobupivacaine of 0.5 % (6 mL) in each side for BSCPB and (3 mL) in each side for BGONB The primary outcome were intraoperative fentanyl consumption, occipital headache, posterior neck, and incision site pains was made at 1, 6, 12 hours and 24 hours after extubation by Visual Analogue Scale (VAS). While the secondary outcomes were postoperative morphine consumption, and the incidence of nausea, vomiting.


The results showed that the intraoperative fentanyl consumption and total post-operative morphine consumption within 24 h were significantly higher (P< 0.05 in the group3 compared to groups1 and2.The mean VAS scores and the proportion of patients with VAS score>4 for post-operative pain at rest and on swallowing showed significantly higher at 6 h and12 h after surgery in group 3 compared to group 1 and 2 with p-value<0.05.As regards mean VAS scores and proportion of patients with VAS score>4for headache and posterior neck pain after surgery at times(1and6h)were significantly lower in Group2,compared to Groups1and3.Postoperative time to take analgesia was significantly longer in groups1and2compared to group3.


The combination of BSCP with BGON blocks was more effective than BSCPB alone in management of pain in thyroid surgery.

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