Effect of adding dexmedetomidine to bupivacaine during superficial combined with ultrasound-guided intermediate cervical plexus block in total thyroidectomy

Abstract

Background Many thyroidectomy patients suffer from pain after surgery that may delay early hospital discharge and place a significant burden on both the patient and the healthcare team. The aim of this study was to evaluate dexmedetomidine as adjuvant to bupivacaine in superficial and ultrasound-guided intermediate cervical plexus block for postoperative analgesia in patients undergoing total thyroidectomy. Patients and methods This prospective, randomized, double-blinded, and controlled study included 50 adult patients of either sex, aged 20–60 years, with American Society of Anathesiologists (ASA) class I or II, scheduled for elective total thyroidectomy under general anesthesia. Results Adding dexmedetomidine to bupivacaine significantly decreased the pain intensity as measured by the visual analog scale compared with group II. Heart rate levels in group I were significantly lower than that in group II in most periods of measurement. The duration of analgesia was prolonged in group I compared with group II, as the time to first dose of rescue analgesia ranged from 12 to 20 h in group I and from 4 to 12 h in group II. The total postoperative nalbuphine consumption was significantly lower in group I than group II. Postanesthesia recovery was significantly faster in group I than group II as measured by the modified Aldrete score 4 min postoperatively. Conclusion Adding dexmedetomidine to bupivacaine for bilateral superficial and ultrasound-guided intermediate cervical plexus block is considered to be an effective and safe method that efficiently managed acute postoperative pain, prolonged the time to first rescue analgesia, and reduced the needed for opioid consumption.