Bilateral Superficial Cervical Plexus Block in Thyroid Surgery with Intravenous versus Local Infiltration of Dexamethasone – A Randomized Single Blinded Comparative Study

Abstract

Background: Post-operative pain for thyroid surgeries under general anaesthesia is inadequately managed. Bilateral superficial cervical plexus block (BSCPB) for thyroid surgery causes adequate analgesia without any significant side effects. Dexamethasone is commonly used in anaesthesia to prevent postoperative nausea and vomiting (PONV). The study objective was comparison of efficacy between add-on Dexamethasone intravenously and Ropivacaine alone in bilateral superficial cervical plexus block versus Dexamethasone added with Ropivacaine in the same block in producing postoperative analgesia and in preventing post-operative nausea vomiting. Methods: Randomized single-blind clinical study was done on eighty patients of 18-60 years of either sex, ASA I and II, scheduled for elective thyroid surgery under general anaesthesia. Patients were divided into two groups (n=40). In bilateral superficial cervical plexus block, Group DB (n=40) had received 20 ml Inj. Ropivacaine (0.25%) and 2ml (8 mg) Inj. Dexamethasone and Group DI (n=40) had received 20ml Inj. Ropivacaine (0.25%) and 2 ml of distilled water, along with 2 ml IV distilled water in DB group and Inj. Dexamethasone 2ml (8 mg) IV in DI group. Time of rescue analgesia with VAS (Visual Analogue Scale) score of that moment and incidence of PONV were noted up to 24 hrs post-operatively. Results: No statistically significant difference was found among the two groups in respect of time of rescue analgesia, VAS score and incidence of PONV. Conclusion: From our study, we conclude that different routes of administration of Inj. Dexamethasone during BSCPB has no extra benefit in respect of postoperative analgesia and incidence of PONV in thyroid surgery.