The effect of adding dexamethasone to the ultrasound-guided intermediate cervical plexus block in thyroidectomy: A double-blind randomized controlled study

Abstract

Abstract Background : A bilateral superficial cervical plexus block provides good analgesia for neck surgery, including thyroidectomy. However, the duration of a single shot nerve block is usually short. Therefore, adjuvants are used in peripheral nerve blocks, especially with ambulatory surgery, where the analgesia duration is very important. Methods : Sixty patients scheduled for thyroidectomy were randomly assigned to one of two groups. Group C received general anesthesia and a bilateral intermediate cervical plexus block with isobaric 10\xa0ml bupivacaine 2%\xa0+\xa02\xa0ml NS deposited on each side. Group D received general anesthesia and bilateral intermediate cervical plexus block with 10\xa0ml isobaric bupivacaine 2%\xa0+\xa04\xa0mg (2\xa0ml) dexamethasone deposited on each side. Primary outcome was postoperative analgesia evaluated by the VAS score. Secondary outcomes were perioperative IL6, blood glucose level, and postoperative nausea and vomiting. Results : Postoperative pain VAS scores were significantly lower in the dexamethasone group than control group; mean VAS score at 6\xa0h postoperatively was 0.4 in Group D vs. 1.8 in Group C; P Conclusion : The addition of 8\xa0mg dexamethasone to ultrasound-guided intermediate cervical plexus block can enhance analgesia duration and reduce postoperative opioid consumption and postoperative IL-6 levels with no significant effect on postoperative glycemic control in non-diabetic patients undergoing thyroidectomy under general anesthesia.