Effectiveness of Bilateral Superficial Cervical Plexus Block as Part of Post-Operative Analgesia for Patient Undergoing Thyroidectomy in Empress Zewditu Memorial Hospital, Addis Ababa, Ethiopia 2017
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Date
2017-06
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Addis Abeba University
Abstract
Introduction: The pain after thyroid surgery is considered of moderate intensity and short
duration. Results of previous study shows the opioid consumption is 90% after thyroid surgery.
Most randomized controlled trial studies showed significant Reduction in pain intensity and
severity of pain in patients for whom BSCPB done when compared to placebo group. There were
also significant difference in time to first analgesia request and total analgesia consumption.
Objective: To assess post-operative analgesic effect of Bilateral Superficial Cervical Plexus
Block for thyroid surgery under general anesthesia at Empress Zewditu Memorial Hospital.
Methods: This prospective cohort study recruits 66 American Society of Anesthesiologist
(ASA) class I and II, age ≥ 18 and euthyroid patient who underwent thyroidectomy randomly.
Manny Whitney test were used to compare median pain score, time to first analgesia request in
minutes and total analgesia consumption between groups. Homogeneity of categorical
independent variable between two exposure groups were analyzed using Chi Square. Box and
whisker plot were used to show a median pain score differences between groups and statistical
significance were sated at p value < 0.05 with a power of 80%.
Results: The comparison of data showed that during recovery room (PACU) time the median
postoperative pain score(NRS) were 3 in exposed group and 5 in non-exposed group (p=0.002).
The comparison also shows lower median pain score 2 compared to 4 at 3rd post-operative time
(p<0.0001).There were also statistically significant difference at 6th ,12th and 24th hour showing
lower median pain score in BSCPB compared to control group. The median time to first
analgesia request in minutes were longer (360 minutes) in exposed group compared to 180
minutes in non-exposed group (p= 0.0006).The median tramadol consumption within 24 hour is
0 mg in exposed group compared to 100 mg in non-exposed group(p=0.001).
Conclusion and Recommendation: Bilateral Superficial cervical plexus block done before
surgery after induction of anesthesia decrease postoperative pain score, total analgesia
consumption and prolong time to first analgesia request for thyroidectomy done under general
anesthesia . Based on these we recommend use of BSCPB with 0.25 bupivacaine is effective
post-operative analgesia.
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Zewditu Memorial Hospital