Background and Aim: Bilateral superficial cervical plexus block provides adequate analgesia in the neck region for thyroid surgery. Intermediate cervical plexus block can block all four cutaneous branches of the cervical plexus and sensory/ motor branches of the cervical plexus supplying the sternocleidomastoid muscle simultaneously so that provides adequate analgesia and anesthesia for neck surgeries that involve manipulation or resection of the sternocleidomastoid muscle. Along with general anesthesia, bilateral superficial cervical plexus block with intermediate cervical plexus block was given to reduce intraoperative opioid requirement and increase the duration of postoperative analgesia.
Material and Methods: A total of 56 patients aged between 18 to 65 years of either sex, ASA I and II, undergoing elective thyroid surgery were randomly allocated in two groups. Group S receives bilateral superficial and intermediate cervical plexus block with Inj. Ropivacaine 0.375% before induction of general anesthesia, and Group C receives no block. In both groups, intraoperative opioid requirement, intraoperative hemodynamics, time of rescue analgesia, total no. of rescue analgesic in 24 hours, total duration of analgesia, and complications were noted.
Results: Group S (\(25\pm0\) micrograms) had less mean fentanyl requirement intraoperatively than group C (\(35\pm14.43\) micrograms). Intraoperative hemodynamics were better in Group S compared to Group C. Total duration of analgesia was prolonged in group S (\(24.57\pm4.72\) hours) than in Group C (\(4.57\pm2.10\) hours). Total no. of rescue analgesic was reduced in group S (8 patients (28.57%)- 1 dose and 20 patients (71.42%)- no analgesic) as compared to group C (7 patients (25%)- 3 doses, 20 patients (71.42%)- 2 doses, one patient (3.57%)- one dose).
Conclusion: Combination of bilateral superficial cervical plexus block with intermediate cervical plexus block reduces intraoperative opioid requirement and increases postoperative analgesia with better intraoperative hemodynamic variables and fewer side effects.
