This prospective observational study evaluates the association between postoperative analgesic approaches and recovery outcomes in patients undergoing elective total thyroidectomy. Patients will be followed under routine clinical care without intervention or randomization.

The primary outcome is the Quality of Recovery-15 (QoR-15) score at 24 hours. Secondary outcomes include swallowing pain, resting pain, opioid consumption, postoperative nausea and vomiting, and additional analgesic requirement.

Inclusion Criteria:

• Patients aged 18-75 years
• ASA physical status classification I-III
• Patients scheduled for elective bilateral total thyroidectomy
• Patients undergoing surgery under general anesthesia
• Individuals able to read and understand Turkish and cognitively capable of completing the QoR-15 questionnaire
• Patients providing written informed consent to participate in the study

Exclusion Criteria:

• Chronic opioid use (≥3 months of regular opioid use)
• Presence of chronic pain syndrome
• Psychiatric illness or cognitive impairment
• History of neurological disease (stroke, dementia, Parkinson's disease, etc.)
• Known allergy to local anesthetic agents
• Previous surgical interventions in the cervical region (including revision thyroid surgery)
• Planned extended surgery with concomitant neck dissection
• Substernal/retrosternal goiter cases (with potential need for sternotomy or additional procedures)
• Emergency surgical procedures
• Patients with ASA physical status IV or higher
• Pregnancy
• Patients expected to require postoperative intensive care
• Patients experiencing intraoperative complications that deviate from the standard monitoring protocol

Adults aged 18-75 years with ASA physical status I-III scheduled for elective bilateral total thyroidectomy under general anesthesia. Participants must be cognitively able to read Turkish and complete the QoR-15 questionnaire and provide written informed consent. Patients with chronic opioid use, chronic pain syndromes, psychiatric or neurological disorders, previous cervical surgery, planned extensive surgery, emergency procedures, pregnancy, or expected postoperative ICU need are excluded.