Superficial cervical plexus block in thyroid surgery and the effect of adding dexamethasone: a randomized, double-blinded study

Abstract

Background Thyroid surgeries are widely performed nowadays as an ambulatory procedure; so, the use of regional block for postoperative analgesia has gained popularity. Bilateral superficial cervical plexus blocks (BSCPB) alone or in combination with deep cervical plexus block are good examples. The duration of analgesia following these nerve blocks last for only a few hours. Patients and methods We randomly allocated 90 patients who are American Society of Anesthesiologists I or II scheduled for thyroid surgeries into three groups according to the contents of cervical block in addition to general anesthesia. Group C, which is the control group, received BSCPB with ropivacaine 0.2%. Group DB received BSCPB with ropivacaine 0.2% plus 8 mg dexamethazone. BSCPB with ropivacaine 0.2% plus 8 mg dexamethazone intravenously was given in group DI. Time to the first administration of supplemental analgesic postoperatively is our primary concern. Secondary outcomes include discharge time, rescue analgesic, rescue antiemetic, postoperative nausea or vomiting, pain score, and side effects of either block or drugs. Results Patients in group DB and DI need less postoperative rescue analgesic requirement than in the control group. Pain scores was statistically significantly less in group DB and in the DI group than in control groups at 6 and 8 h postoperatively. The occurrence of nausea and/or vomiting is statistically significantly less frequent in groups DB and DI when compared with the control group postoperatively. Conclusion The addition of dexamethasone to BSCPB resulted in decrease in time that elapsed until the first administration of supplemental analgesic, improved pain control, and reduced analgesic requirements postoperatively. This finding does not differ if dexamethazone is given either with block or intravenously.