Bilateral Superficial Cervical Plexus Block Combined With Intravenous Sedation Versus General Anesthesia in Selected Patients for Thyroid/Parathyroid Surgery ; a Prospective Randomized Control Trial
Overview
- Phase
- Not Applicable
- Intervention
- Bilateral superficial cervical plexus block with 0.25% bupivacaine 8 ml each (total 16 ml)
- Conditions
- Benign Tumor of Thyroid
- Sponsor
- Mahidol University
- Enrollment
- 52
- Locations
- 1
- Primary Endpoint
- Postoperative pain score at rest
- Last Updated
- 4 years ago
Overview
Brief Summary
To compare efficacy and safety between bilateral superficial cervical plexus block combined with intravenous sedation (RA group) and general anesthesia (GA group) for thyroid and parathyroid operations. This study evaluates postoperative numerical pain score and systemic opioid requirement within 24 hours.
Detailed Description
According to literature review, there is limit information about efficacy and safety of thyroid and parathyroid operations under bilateral superficial cervical plexus block combined with intravenous sedation without general anesthesia. General anesthesia is commonly used for neck operations because it is easy to perform. However in high cardiovascular or pulmonary risk patients such as end stage renal disease (ESRD) patients, regional anesthesia such as superficial cervical plexus block combined with intravenous sedation have become an alternative technique for neck operations. This study evaluate whether regional anesthesia (RA) technique can be the alternative technique for thyroid/parathyroid surgery compare to conventional technique (GA).
Investigators
Suwimon Tangwiwat
Assistant professor, Department of Anesthesiology
Mahidol University
Eligibility Criteria
Inclusion Criteria
- •American Society of Anesthesiologists (ASA) grade I-III, aged over 18 years
- •Elective thyroidectomy, thyroid lobectomy, parathyroidectomy
Exclusion Criteria
- •Language barrier or inability to communicate with the operating team
- •Allergy to local anaesthetic
- •Known substernal, retroesophageal or retrotracheal goiter
- •Thyroid cancer
- •Previous neck exploration or neck radiation
- •Recurrent laryngeal nerve paralysis
Arms & Interventions
bilateral cervical plexus block
bilateral superficial cervical plexus block with 0.25% bupivacaine 8 ml each (total 0.25% bupivacaine 16 mg)
Intervention: Bilateral superficial cervical plexus block with 0.25% bupivacaine 8 ml each (total 16 ml)
bilateral cervical plexus block
bilateral superficial cervical plexus block with 0.25% bupivacaine 8 ml each (total 0.25% bupivacaine 16 mg)
Intervention: Dexmedetomidine plus propofol infusion
bilateral cervical plexus block
bilateral superficial cervical plexus block with 0.25% bupivacaine 8 ml each (total 0.25% bupivacaine 16 mg)
Intervention: Local infiltraion analgesia
General anesthesia
General anesthesia with endotracheal intubation under total intravenous anesthesia (TIVA)
Intervention: Dexmedetomidine plus propofol infusion
General anesthesia
General anesthesia with endotracheal intubation under total intravenous anesthesia (TIVA)
Intervention: Local infiltraion analgesia
General anesthesia
General anesthesia with endotracheal intubation under total intravenous anesthesia (TIVA)
Intervention: General anesthesia with endotracheal tube
Outcomes
Primary Outcomes
Postoperative pain score at rest
Time Frame: 24 hours at ward
Numerical rating scale 0-10 (0=no pain, 10= worst pain imaginable)
Secondary Outcomes
- Patient's satisfaction scale score(at 24 hours)
- Postoperative morphine consumption(Cumulative dose within 24 hours)
- Postoperative pain score on swallow(average NRS at ward at 24 hours)
- Complications(within 24 hours)