Ultrasound-guided bilateral superficial cervical plexus blocks enhance the quality of recovery in patients undergoing thyroid cancer surgery: A randomized controlled trial

• Published in: Journal of clinical anesthesia Vol. 61; p. 109651
• Main Authors: Yao, Yusheng, Lin, Cailing, He, Qiaolan, Gao, Hongxin, Jin, Lufen, Zheng, Xiaochun
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2020; Elsevier Limited
• Subjects: Analgesics; Anesthesia; Cancer surgery; Clinical trials; Intubation; Local anesthesia; Pain; Patient satisfaction; Postoperative nausea or vomiting; Postoperative pain; Quality of recovery; Recovery (Medical); Statistical analysis; Superficial cervical plexus block; Thyroid cancer; Thyroid cancer surgery; Ultrasonic imaging; Ultrasound-guided; United States > US; Quality of recovery; Postoperative pain; Postoperative nausea or vomiting; Thyroid cancer surgery; Ultrasound-guided; Superficial cervical plexus block
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/j.jclinane.2019.109651

Regional anesthesia can improve postoperative analgesia and enhance the quality of recovery (QoR) after surgery. This trial evaluates the effects of ultrasound-guided bilateral superficial cervical plexus block (SCPB) on QoR in patients undergoing thyroid cancer surgery. Prospective, randomized, double-blinded, placebo-controlled trial. Operating room. Seventy-four ASA I–II female patients scheduled for thyroid cancer surgery were included to the study. Patients were randomly allocated to receive pre-operative ultrasound-guided bilateral SCPB with 10 ml of ropivacaine 0.5% or normal saline on each side. The primary endpoint was the quality of recovery, which was assessed using the 15-item quality of recovery questionnaire (QoR-15). Secondary endpoints were acute postoperative pain, time to first rescue analgesia, the number of patients requiring rescue analgesia, length of post-anesthesia care unit (PACU) stay, the incidence of postoperative nausea or vomiting (PONV) and dizziness, and patient satisfaction. The global QoR-15 score at 24 h postoperatively was significantly higher in the SCPB group (Median [IQR], 118 [115–120]) than the control group (110 [106–112]) with a median difference of 8 (95% CI: 6 to 10, P < .001). Compared with the control group, pre-operative ultrasound-guided bilateral SCPB reduced postoperative pain up to 24 h and the incidence of PONV, as well as the length of PACU stay. Additionally, the patient satisfaction scores were improved in the SCPB group (P = .024). Pre-operative ultrasound-guided bilateral SCPB with ropivacaine enhances the quality of recovery, postoperative analgesia and patient satisfaction, alleviates the incidence of PONV, and accelerates the PACU discharge following thyroid cancer surgery. •Pre-operative ultrasound-guided SCPB enhances the quality of recovery after thyroid cancer surgery.•Pre-operative ultrasound-guided SCPB reduces pain and the incidence of PONV during the first 24 hours postoperatively.•Pre-operative ultrasound-guided SCPB improves patient satisfaction following thyroid cancer surgery.