Ultrasound-guided bilateral superficial cervical plexus block for thyroid surgery: The effect of dexmedetomidine addition to bupivacaine-epinephrine
Background: The thyroid gland surgery is a common and painful procedure demanding analgesia. Many regional techniques are applied for anterior neck surgeries mostly assigned in relation to the involved cervical fascia. Dexmedetomidine (Precedex) is a selective alpha 2 adrenoceptor agonist which prol...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2018-01-01
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| Series: | Saudi Journal of Anaesthesia |
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| Online Access: | http://www.saudija.org/article.asp?issn=1658-354X;year=2018;volume=12;issue=3;spage=412;epage=418;aulast=Elmaddawy |
| _version_ | 1819236697036029952 |
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| author | Alaa Eldin Adel Elmaddawy Alaa Eldin Mazy |
| author_facet | Alaa Eldin Adel Elmaddawy Alaa Eldin Mazy |
| author_sort | Alaa Eldin Adel Elmaddawy |
| collection | DOAJ |
| description | Background: The thyroid gland surgery is a common and painful procedure demanding analgesia. Many regional techniques are applied for anterior neck surgeries mostly assigned in relation to the involved cervical fascia. Dexmedetomidine (Precedex) is a selective alpha 2 adrenoceptor agonist which prolongs the sensory blockade duration of local anesthetics. Our study hypothesis is that ultrasound (US)-guided bilateral superficial cervical plexus block (BSCPB) may provide longer analgesia when adding dexmedetomidine to bupivacaine-epinephrine.
Purpose: The aim of this study is to evaluate the analgesic efficacy and possible side effects of US-guided BSCPB and the effect of dexmedetomidine addition to bupivacaine-epinephrine in patients undergoing thyroid surgery.
Methods: This prospective, double-blind, randomized study was performed on 42 patients randomized into two equal groups each of 21; bupivacaine Group B and dexmedetomidine Group D. Patients with contraindications to regional anesthesia or uncontrolled comorbidities were excluded from the study. Total pethidine consumption in 24 h is the primary outcome. The visual analog scale, timing of the first opioid request, and hemodynamics are the secondary outcomes.
Results: In Group D, there was a longer time to the first request of opioid postoperatively, a lower total pethidine consumption and pain score postoperatively, and lower fentanyl requirements intraoperatively.
Conclusions: Sonographic-guided bilateral SCPB using a combination of bupivacaine, dexmedetomidine, and epinephrine was superior to bupivacaine for prolonged analgesia with less intra- and postoperative opioid consumption and lower side effect profile during thyroid surgery. |
| first_indexed | 2024-12-23T13:08:33Z |
| format | Article |
| id | doaj.art-435bbaddae044f0596174f7d9f31b4ac |
| institution | Directory Open Access Journal |
| issn | 1658-354X |
| language | English |
| last_indexed | 2024-12-23T13:08:33Z |
| publishDate | 2018-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Saudi Journal of Anaesthesia |
| spelling | doaj.art-435bbaddae044f0596174f7d9f31b4ac2022-12-21T17:45:49ZengWolters Kluwer Medknow PublicationsSaudi Journal of Anaesthesia1658-354X2018-01-0112341241810.4103/sja.SJA_653_17Ultrasound-guided bilateral superficial cervical plexus block for thyroid surgery: The effect of dexmedetomidine addition to bupivacaine-epinephrineAlaa Eldin Adel ElmaddawyAlaa Eldin MazyBackground: The thyroid gland surgery is a common and painful procedure demanding analgesia. Many regional techniques are applied for anterior neck surgeries mostly assigned in relation to the involved cervical fascia. Dexmedetomidine (Precedex) is a selective alpha 2 adrenoceptor agonist which prolongs the sensory blockade duration of local anesthetics. Our study hypothesis is that ultrasound (US)-guided bilateral superficial cervical plexus block (BSCPB) may provide longer analgesia when adding dexmedetomidine to bupivacaine-epinephrine. Purpose: The aim of this study is to evaluate the analgesic efficacy and possible side effects of US-guided BSCPB and the effect of dexmedetomidine addition to bupivacaine-epinephrine in patients undergoing thyroid surgery. Methods: This prospective, double-blind, randomized study was performed on 42 patients randomized into two equal groups each of 21; bupivacaine Group B and dexmedetomidine Group D. Patients with contraindications to regional anesthesia or uncontrolled comorbidities were excluded from the study. Total pethidine consumption in 24 h is the primary outcome. The visual analog scale, timing of the first opioid request, and hemodynamics are the secondary outcomes. Results: In Group D, there was a longer time to the first request of opioid postoperatively, a lower total pethidine consumption and pain score postoperatively, and lower fentanyl requirements intraoperatively. Conclusions: Sonographic-guided bilateral SCPB using a combination of bupivacaine, dexmedetomidine, and epinephrine was superior to bupivacaine for prolonged analgesia with less intra- and postoperative opioid consumption and lower side effect profile during thyroid surgery.http://www.saudija.org/article.asp?issn=1658-354X;year=2018;volume=12;issue=3;spage=412;epage=418;aulast=ElmaddawyDexmedetomidine; superficial cervical plexus block; thyroid surgery; ultrasound |
| spellingShingle | Alaa Eldin Adel Elmaddawy Alaa Eldin Mazy Ultrasound-guided bilateral superficial cervical plexus block for thyroid surgery: The effect of dexmedetomidine addition to bupivacaine-epinephrine Saudi Journal of Anaesthesia Dexmedetomidine; superficial cervical plexus block; thyroid surgery; ultrasound |
| title | Ultrasound-guided bilateral superficial cervical plexus block for thyroid surgery: The effect of dexmedetomidine addition to bupivacaine-epinephrine |
| title_full | Ultrasound-guided bilateral superficial cervical plexus block for thyroid surgery: The effect of dexmedetomidine addition to bupivacaine-epinephrine |
| title_fullStr | Ultrasound-guided bilateral superficial cervical plexus block for thyroid surgery: The effect of dexmedetomidine addition to bupivacaine-epinephrine |
| title_full_unstemmed | Ultrasound-guided bilateral superficial cervical plexus block for thyroid surgery: The effect of dexmedetomidine addition to bupivacaine-epinephrine |
| title_short | Ultrasound-guided bilateral superficial cervical plexus block for thyroid surgery: The effect of dexmedetomidine addition to bupivacaine-epinephrine |
| title_sort | ultrasound guided bilateral superficial cervical plexus block for thyroid surgery the effect of dexmedetomidine addition to bupivacaine epinephrine |
| topic | Dexmedetomidine; superficial cervical plexus block; thyroid surgery; ultrasound |
| url | http://www.saudija.org/article.asp?issn=1658-354X;year=2018;volume=12;issue=3;spage=412;epage=418;aulast=Elmaddawy |
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