TO COMPARE THE ANALGESIC EFFICACY OF 0.2% ROPIVACAINE WITH DEXMEDETOMIDINE AND 0.2% ROPIVACAINE WITH DEXAMETHASONE IN USG GUIDED BILATERAL SUPERFICIAL CERVICAL PLEXUS BLOCK FOR THYROID SURGERY UNDER GENERAL ANAESTHESIA – A RANDOMIZED STUDY

Abstract

Background: Postoperative pain after thyroid surgery is usually mild to moderate but it may increase analgesic requirement and reduce early patient comfort. Ultrasound-guided bilateral superficial cervical plexus block is a useful regional technique for thyroid surgery. Different adjuvants may improve the duration and quality of analgesia. Materials and Methods: This randomized prospective study was conducted in the Department of Anaesthesiology, MGM Medical College and M.Y. Hospital, Indore. Seventy patients aged 18–65 years, ASA physical status I–III, scheduled for elective thyroid surgery under general anaesthesia were included. Patients were divided into two groups of 35 each. Group A received ultrasound-guided bilateral superficial cervical plexus block with 0.2% ropivacaine and dexmedetomidine 50 mcg. Group B received 0.2% ropivacaine and dexamethasone 4 mg. Duration of analgesia, postoperative VAS score, total tramadol consumption, haemodynamic parameters and adverse effects were recorded. Results: Both groups were comparable for baseline parameters and duration of surgery. Duration of analgesia was significantly longer in Group A than Group B, 7.90 ± 0.75 hours versus 5.61 ± 0.67 hours (p < 0.0001). Total tramadol consumption during 24 hours was significantly lower in Group A, 65.71 ± 18.27 mg compared with 125.00 ± 19.63 mg in Group B (p < 0.0001). VAS score was significantly lower in Group A at 6 hours and 12 hours. Heart rate and mean arterial pressure remained comparable between the groups. Nausea and vomiting was higher in Group A. Conclusion: Dexmedetomidine as an adjuvant to 0.2% ropivacaine in ultrasound-guided bilateral superficial cervical plexus block provided longer analgesia and reduced tramadol consumption compared with dexamethasone. Both groups maintained stable haemodynamics