Comparison between ultrasound guided and landmark – based technique for superficial cervical plexus block in patients undergoing thyroid surgery

Abstract

Background: The major advantage of ultrasound guided technique over the traditional landmark technique in bilateral superficial cervical plexus block is that, it helps to minimize the injury to cervical muscle, fascia and nerves. The study aimed to compare the effectiveness between landmark technique and ultrasound guided technique with respect to the post-operative analgesia, intra-operative hemodynamics and the complication rate of the procedure. Methodology: A total of 100 patients were included as our study sample which was divided into two groups of 50 each. Group A patients received Superficial Cervical Plexus Block (SCPB) using the landmark based technique and Group B patients received SCPB under ultrasound guided technique. Parameters such as success of the procedure performance time, time of onset of action, block pain score, post-operative pain score, intra-operative hemodynamics and complication rate were compared between the two groups. Results: The success rate of the block was found to be 72% in the landmark technique group compared to 90% in the ultrasound guided group. The onsite time of analgesia was found to be much earlier in ultrasound guided group (16.2 vs 11.1 mins). The hemodynamic parameters were found to be slightly higher among the landmark group compared to ultrasound guided group. Post-operative pain score was significantly better and the incidence of complication rate was nil among ultrasound guided group. Conclusion: Ultrasound guided technique is a better alternate for landmark technique for providing bilateral superficial cervical plexus block while performing thyroidectomy surgery. Keywords: cervical plexus block; landmark technique; ultrasound technique; thyroidectomy