Mostafa Mamdouh Mahmoud, Gamal Reham M, Ahmed Baiomy Aya M, Hassan Mohamed Elsayed, Kamal Jehan Mohamed, Ts Thabet, Kotb Tamer A, Elrawas Mai M
Department of Anesthesia, SICU and pain Management, National Cancer Institute, Cairo University, Cairo, Egypt.
BMC Anesthesiol. 2025 Mar 25;25(1):139. doi: 10.1186/s12871-025-02990-7.
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.
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.
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.
The addition of dexmedetomidine to bupivacaine in ultrasound-guided intermediate CPB for thyroidectomy significantly prolonged analgesia and reduced postoperative opioid consumption.
甲状腺切除术后成功恢复的一个重要方面是术后疼痛程度。本研究旨在确定超声引导下颈丛神经阻滞（CPB）联合右美托咪定辅助布比卡因用于甲状腺切除术的有效性。主要结局指标是镇痛持续时间，定义为至首次要求使用补救镇痛药的时间。次要结局指标包括术中芬太尼总消耗量、术后24小时内患者阿片类药物总需求量、视觉模拟评分（VAS）以及并发症。
本随机对照双盲研究纳入60例年龄在18至60岁之间、因甲状腺癌接受甲状腺切除术的患者。患者被随机分为两组，每组30例。B组接受双侧颈丛神经阻滞，注射20ml 0.25%布比卡因；DB组接受双侧颈丛神经阻滞，注射20ml 0.25%布比卡因加1μg/kg右美托咪定。
DB组的镇痛持续时间显著更长（p < 0.001），术中芬太尼总消耗量显著更少（p = 0.005），术后吗啡总消耗量显著更少（p < 0.001）。此外，DB组术后疼痛评分、心率和平均动脉压均显著低于B组。
在超声引导下颈丛神经阻滞用于甲状腺切除术时，在布比卡因中添加右美托咪定可显著延长镇痛时间并减少术后阿片类药物的消耗量。
