Cervical Erector Spinae Plane Block vs Cervical Plexus Block in Controlling Acute Postoperative Pain After Thyroidectomy: A Randomized Controlled Study
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Cairo University
- Enrollment
- 40
- Locations
- 1
- Primary Endpoint
- Total morphine consumption
Study Overview
Brief Summary
This study aims to compare the efficacy and safety of cervical erector spinae plane block vs. cervical plexus block in controlling acute postoperative pain after thyroidectomy.
Detailed Description
Thyroidectomy is one of the most commonly performed surgeries in females worldwide, as thyroid disease predominantly affects females with a ratio of 4:1. Thyroid operations can cause mild to moderate incisional pain. It has also been reported that the morphine consumption on the first postoperative day is 90%.
Cervical plexus block, either superficial or deep or combinations given bilaterally, could easily lead to an adequate block appropriate for thyroid surgery without any significant side effects.
Erector spinae plane block (ESPB) is the new favorite among various fascial plane blocks. Local anesthetic drug is injected in the fascial plane superficial to the transverse process and deeper to the erector spinae muscle (ESM).
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to 65 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Age from 18 to 65 years.
- •Both genders.
- •American Society of Anesthesiologists (ASA) physical status I-II.
- •Scheduled for either hemi- or total thyroidectomy.
Exclusion Criteria
- •Known allergy to local anesthetics.
- •Allergy to all opioid medications.
- •Pregnant patient.
- •Previous neck surgery.
- •Recent use of non-steroidal anti-inflammatory drugs (NSAIDs), opioids or steroid injection within 2 weeks.
- •Those who cannot utilize the numeric rating scale (NRS) .
- •Chronic opioid use.
- •Coagulopathy.
Arms & Interventions
ESPB group
Patients will receive bilateral ultrasound-guided cervical erector spinae plane block using 15 ml of bupivacaine 0.25% on each side.
Intervention: Cervical erector spinae plane block (Other)
SCPB group
Patients will receive bilateral ultrasound-guided superficial cervical block using 15 mL of 0.25% plain bupivacaine on each side of the neck.
Intervention: Cervical plexus block (Other)
Outcomes
Primary Outcomes
Total morphine consumption
Time Frame: 48 hours postoperatively
Rescue analgesia of morphine will be given as 3 mg bolus if the numeric rating scale (NRS) \> 3 to be repeated after 30 min if pain persists until the NRS \< 4.
Secondary Outcomes
- Degree of pain(48 hours postoperatively)
- Time to the 1st rescue analgesia(48 hours postoperatively)
- Intraoperative fentanyl consumption(Intraoperatively)
- Incidence of adverse events(48 hours postoperatively)
Investigators
Mohamed Elsaid Abdel Fattah
Lecturer of Anesthesia, Surgical ICU and Pain Management, Faculty of Medicine, National Cancer Institute, Cairo University, Egypt.
Cairo University