Bilateral Superficial Cervical Plexus Block in Thyroid/Parathyroid Surgery

Bilateral Superficial Cervical Plexus Block Combined With Intravenous Sedation Versus General Anesthesia in Selected Patients for Thyroid/Parathyroid Surgery ; a Prospective Randomized Control Trial

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.

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).

bilateral superficial cervical plexus block with 0.25% bupivacaine 8 ml each (total 0.25% bupivacaine 16 mg)

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 BMI ≥ 30

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