The use of ketorolac as an adjuvant in the superficial cervical plexus block

Abstract

Background Thyroidectomy operation is considered a common operation done nowadays. Pain after thyroidectomy is moderate to severe in some patients. Many techniques are used to provide analgesia and to avoid opioid adverse effects such as local wound infiltration, and regional anesthesia techniques like bilateral superficial cervical plexus block (BSCPB), alone or in combination with deep cervical plexus block. Patients and methods In this prospective, randomized, and double‑blind study, 46 patients were randomly allocated into two equal groups (23 in each group): the bupivacaine group (group B) received BSCPB with 10 ml of 0.25% bupivacaine and 1 ml normal saline on each side and the bupivacaine ketorolac group (group BK) received 10 ml of 0.25% bupivacaine and 1 ml ketorolac (15 mg) on each side. The first-time supplemental analgesia needed postoperatively was our primary outcome. Secondary outcomes include total analgesic consumption, visual analog score, patient satisfaction, and adverse effects. Results visual analog score at 8, 16, and 24 h and total ketorolac requirements were significantly lower (P=0.001 and 0.02, respectively), whereas the time to first rescue analgesic requirement was significantly longer in group BK when compared with group B (P=0.001). The frequency of nausea and vomiting was not statistically significant with less incidence in group BK compared with group B. Throat pain frequency was significantly less in group BK (P=0.05). Patient satisfaction was statistically significant in group BK (P=0.03). Conclusion Adding ketorolac to bupivacaine in BSCPB improved the control of pain, increased the pain-free period, decreased postoperative analgesic needs, and decreased adverse effects.