Efficacy of adding dexmedetomidine as adjuvant with bupivacaine in ultrasound-guided intermediate cervical plexus block for thyroidectomy surgery: randomized controlled study.

Abstract

Background: One important aspect of a successful thyroidectomy recovery is the level of pain postoperatively. This research aimed to determine the effectiveness of an ultrasound-guided intermediate cervical plexus block (CPB) for thyroidectomy with dexmedetomidine added as an adjuvant to bupivacaine. The primary outcome was the duration of analgesia defined as the time till the first request for rescue analgesia. The secondary outcomes were the total amount of fentanyl consumed intraoperatively, total patient's opioids requirements within 24 h postoperative, VAS, and complications.

Methods: This randomized controlled double-blinded study included 60 patients aged 18 to 60 years, all of whom underwent thyroidectomy for thyroid cancer. Patients were randomly allocated into two equal groups, the B Group (n = 30) received bilateral intermediate CPB, with 20 ml bupivacaine 0.25%, and the DB Group (n = 30) received bilateral intermediate CPB with 20 ml of bupivacaine 0.25% plus 1 µg/kg dexmedetomidine.

Results: The DB Group showed a significantly longer duration of analgesia (p < 0.001), significantly less total intraoperative fentanyl consumption (p = 0.005), and significantly less total postoperative morphine consumption (p < 0.001). Also, postoperative pain scores, heart rate, and mean arterial pressure were significantly lower in the DB group than in the B Group and sometimes points.

Conclusions: The addition of dexmedetomidine to bupivacaine in ultrasound-guided intermediate CPB for thyroidectomy significantly prolonged analgesia and reduced postoperative opioid consumption.