Volume 29, Issue 137 (November & December 2021)                   J Adv Med Biomed Res 2021, 29(137): 346-351 | Back to browse issues page

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Hashemian M, Mirafzal A, Noroozi M, Kazemi M, Samadi S. The Effects of Ultrasound-guided and Anatomic landmark-based Superficial Cervical Plexus Block on Post-operative Pain Intensity in Thyroidectomy Patients: A Clinical Trial. J Adv Med Biomed Res 2021; 29 (137) :346-351
URL: http://journal.zums.ac.ir/article-1-6221-en.html
The Effects of Ultrasound-guided and Anatomic landmark-based Superficial Cervical Plexus Block on Post-operative Pain Intensity in Thyroidectomy Patients: A Clinical Trial
Morteza Hashemian1 , Amirhossein Mirafzal2 , Mehrdad Noroozi3 , Majid Kazemi4 , Sadra Samadi *5
1- Dept. of Anesthesiology and Pain Medicine, Kerman University of Medical Sciences, Kerman, Iran
2- Dept. of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran
3- Dept. of Anesthesiology, Isfahan University of Medical Sciences, Isfahan, Iran
4- School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
5- Dept. of Anesthesiology and Pain Medicine, Kerman University of Medical Sciences, Kerman, Iran , Samadi_sadra@yahoo.com
Abstract:   (120261 Views)

Background and Objective: Pain is one of the most common complications after thyroidectomy. Opioid administration can overcome this complication, however, it has some side effects, including nausea and vomiting. So, the use of local anesthetic instead of opioids is a good alternative. This study was conducted to evaluate and compare the effect of ultrasound-guided superficial cervical plexus block (SCPB) versus anatomic landmark (LM)-based SCPB on post-operative severity of pain after thyroidectomy.
Materials and Methods: In this clinical trial 113 patients were selected through convenience sampling method. Patients were randomly divided in to three groups: a) control, b) LM-based nerve block, and c) ultrasound-guided nerve block. Data collection was performed by demographic checklist and visual analogue scale (VAS). After general anesthesia, nerve block was performed by 15 mL of 0.25% Bupivacaine solution. Postoperative pain was measured in post anesthesia care unit (PACU) at 3, 6, 9, 12 and 24 hours. One-way analysis of variance (ANOVA), chi-square and fisher exact tests and repeated measurements were used for data analysis (SPSS V.18 software).
Results: Patients of group c in comparison to other groups received lower analgesic dose during operation (p≤0.001); fewer of them needed post-operative analgesia (p≤0.001). The ultrasound-guided SCPB group had significantly lower pain severity in comparison to other groups in different time intervals (p≤0.001).
Conclusion: Ultrasound-guided superficial cervical plexus block reduced the pain after thyroidectomy. However, the ultrasound-guided nerve block is a well-organized and expanding technique, but it needs more practice and training.

Keywords: Superficial cervical plexus block, Thyroidectomy, Pain intensity, Landmark (LM), Ultrasound
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✅ Ultrasound-guided superficial cervical plexus block reduced the pain after thyroidectomy. However, the ultrasound-guided nerve block is a well-organized and expanding technique, but it needs more practice and training.


Type of Study: Original Research Article | Subject: Clinical Medicine
Received: 2020/11/14 | Accepted: 2021/05/7 | Published: 2021/08/1
References
1. Dunn JT. Guarding our nation's thyroid health. J Clin Endocrinol Metab. 2002;87(2):486-8. [DOI:10.1210/jc.87.2.486]
2. Clark OH, Duh QY, Kebebew E. Textbook of endocrine surgery: JP Medical Ltd; 2016.
3. Shih ML, Duh QY, Hsieh CB, et al. Bilateral superficial cervical plexus block combined with general anesthesia administered in thyroid operations. World J Surg. 2010;34(10):2338-43. [DOI:10.1007/s00268-010-0698-7]
4. Wang Q, Li Z, Xu S, et al. Feasibility of ultrasound-guided capsule-sheath space block combined with anterior cervical cutaneous nerves block for thyroidectomy: an observational pilot study. BMC Anesthesiol. 2015;15(1):4. [DOI:10.1186/1471-2253-15-4]
5. Halaszynski TM, Tom M. Ultrasound-guided peripheral nerve blocks. Basic Clinical Anesthesia: Springer; 2015. p. 253-63. [DOI:10.1007/978-1-4939-1737-2_23]
6. Marhofer P, Chan VW. Ultrasound-guided regional anesthesia: current concepts and future trends. Anesthesia & Analgesia. 2007;104(5):1265-9. [DOI:10.1213/01.ane.0000260614.32794.7b]
7. Willschke H, Marhofer P, Bösenberg A, et al. Ultrasonography for ilioinguinal/iliohypogastric nerve blocks in children. Br J Anaesthesia. 2005;95(2):226-30. [DOI:10.1093/bja/aei157]
8. Koscielniak‐Nielsen Z. Ultrasound‐guided peripheral nerve blocks: what are the benefits? Acta Anaesthesiologica Scandinavica. 2008;52(6):727-37. [DOI:10.1111/j.1399-6576.2008.01666.x]
9. Yao Y, Lin C, He Q, Gao H, Jin L, Zheng X. Ultrasound-guided bilateral superficial cervical plexus blocks enhance the quality of recovery in patients undergoing thyroid cancer surgery: A randomized controlled trial. J Clin Anesthesia. 2020;61:109651. [DOI:10.1016/j.jclinane.2019.109651]
10. Elmaddawy AEA, Mazy AE. Ultrasound-guided bilateral superficial cervical plexus block for thyroid surgery: The effect of dexmedetomidine addition to bupivacaine-epinephrine. Saudi J Anaesthesia. 2018;12(3):412. [DOI:10.4103/sja.SJA_653_17]
11. HR A. Ultrasound-guided brachial plexus block: a study on 30 patients. Tehran University Medical Journal TUMS Publications. 2009;67(2):151-7.
12. Senapathi TGA, Widnyana IMG, Aribawa IGNM, et al. Ultrasound-guided bilateral superficial cervical plexus block is more effective than landmark technique for reducing pain from thyroidectomy. J Pain Res. 2017;10:1619. [DOI:10.2147/JPR.S138222]
13. Sohoni A, Nagdev A, Takhar S, Stone M. Forearm ultrasound-guided nerve blocks vs landmark-based wrist blocks for hand anesthesia in healthy volunteers. Am J Emerg Med. 2016;34(4):730-4. [DOI:10.1016/j.ajem.2016.01.020]
14. Entezari S, Mohsenpour AM, Imani F, Alebouyeh M, Zafarghandi M. Supraclavicular block with sonography alone or combined with nerve-stimulation: Which one is more effective? 2013;3(4):229-34.
15. Sandhu N, Capan L. Ultrasound‐guided infraclavicular brachial plexus block. Br J Anaesthesia. 2002;89(2):254-9. [DOI:10.1093/bja/aef186]
16. Vieira PA, Pulai I, Tsao GC, Manikantan P, Keller B, Connelly NR. Dexamethasone with bupivacaine increases duration of analgesia in ultrasound-guided interscalene brachial plexus blockade. Europ J Anaesthesiol. 2010;27(3):285-8. [DOI:10.1097/EJA.0b013e3283350c38]
17. Auroy Y, Benhamou D, Bargues L, et al. Major complications of regional anesthesia in France.The SOS Regional Anesthesia Hotline Service. Anesthesiology 2002;97(5):1274-80. [DOI:10.1097/00000542-200211000-00034]
18. Bigeleisen P, Wilson M. A comparison of two techniques for ultrasound guided infraclavicular block. Br J Anaesth. 2006;96(4):502-7. [DOI:10.1093/bja/ael024]
19. Schafhalter-Zoppoth I, Zeitz ID, Gray A. Ultrasound evidence of intraneural injection. Anesthesia & Analgesia. 2005;101(2):611. [DOI:10.1213/01.ANE.0000159011.02691.23]
20. Marhofer P, Schrögendorfer K, Wallner T, Koinig H, Mayer N, Kapral S. Ultrasonographic guidance reduces the amount of local anesthetic for 3-in-1 blocks. Reg Anesthesia Pain Medicine. 1998;23(6):584-8. [DOI:10.1097/00115550-199823060-00013]
21. Hashemi SM, Akhyani V, Dadkhah P, Jalili P, Poorfarokh M, Saafi E. Evaluation of diagnostic accuracy of sacroiliac joint block under sonographic guidance in low back and pelvic pain. Neurosci J Shefaye Khatam. 2014;2(2):31-40 . [DOI:10.18869/acadpub.shefa.2.2.31]
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