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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.
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).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ESPB group | Experimental | Patients will receive bilateral ultrasound-guided cervical erector spinae plane block using 15 ml of bupivacaine 0.25% on each side. |
|
| SCPB group | Active Comparator | Patients will receive bilateral ultrasound-guided superficial cervical block using 15 mL of 0.25% plain bupivacaine on each side of the neck. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cervical erector spinae plane block | Other | Patients will receive bilateral ultrasound-guided cervical erector spinae plane block using 15 ml of bupivacaine 0.25% on each side. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Total morphine consumption | 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. | 48 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Time to the 1st rescue analgesia | Time to the first request for the rescue analgesia (time from end of surgery to first dose of morphine administrated). | 48 hours postoperatively |
| Intraoperative fentanyl consumption |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cairo University | Cairo | 12613 | Egypt |
The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
After the end of study for one year.
The data will be available upon a reasonable request from the corresponding author.
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|
| Cervical plexus block | Other | Patients will receive bilateral ultrasound-guided superficial cervical block using 15 mL of 0.25% plain bupivacaine on each side of the neck. |
|
|
Additional bolus doses of fentanyl 1 µg/kg will be given if the mean arterial blood pressure (MAP) or heart rate (HR) rises above 20% of baseline levels.
| Intraoperatively |
| Degree of pain | Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS) score. NRS (0 represents "no pain" while 10 represents "the worst pain imaginable"). NRS will be assessed at post-anesthesia care unit (PACU), 1, 2, 4, 6, 8, 12, 18, 24, 36 and 48 h postoperative. | 48 hours postoperatively |
| Incidence of adverse events | Incidence of adverse events such as nausea, vomiting, hypotension, bradycardia, cough, bronchospasm, and sore throat will be recorded. | 48 hours postoperatively |
| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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| ID | Term |
|---|---|
| D066008 | Cervical Plexus Block |
| ID | Term |
|---|---|
| D009407 | Nerve Block |
| D000765 | Anesthesia, Conduction |
| D000758 | Anesthesia |
| D000760 | Anesthesia and Analgesia |
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