Ultrasound-guided bilateral superficial cervical block and preemptive single-dose oral tizanidine for post-thyroidectomy pain: a randomized-controlled double-blind study

• Published in: Journal of anesthesia 2018-04, Vol.32 (2), p.219-226
• Main Authors: Ahiskalioglu, Ali, Yayik, Ahmet Murat, Oral Ahiskalioglu, Elif, Dostbil, Aysenur, Doymus, Omer, Karadeniz, Erdem, Ari, Muhammet Ali, Sengoz, Furkan, Alici, Haci Ahmet, Celik, Erkan Cem
• Format: Article
• Language: English
• Subjects: Adult; Analgesia, Patient-Controlled; Analgesics - administration & dosage; Analgesics, Opioid - therapeutic use; Anesthesia, General - methods; Anesthesiology; Anesthetics, Local - administration & dosage; Bupivacaine - therapeutic use; Clonidine - administration & dosage; Clonidine - analogs & derivatives; Complications and side effects; Critical Care Medicine; Dosage and administration; Double-Blind Method; Drug therapy; Emergency Medicine; Female; Fentanyl - therapeutic use; Humans; Intensive; Male; Medicine; Medicine & Public Health; Middle Aged; NCT; NCT02725359; Nerve Block - methods; Original Article; Pain Medicine; Pain, Postoperative - drug therapy; Patient outcomes; Postoperative pain; Propofol - therapeutic use; Risk factors; Thyroidectomy; Thyroidectomy - adverse effects; Thyroidectomy - methods; Tizanidine
• ISSN: 0913-8668; 1438-8359
• DOI: 10.1007/s00540-018-2468-x

Purposes The postoperative analgesic effect of tizanidine has not yet been evaluated sufficiently. The role of bilateral superficial cervical plexus block (BSCPB) for postoperative analgesia after thyroidectomy remains questionable. We aimed to evaluate the analgesic effect of combined use of BSCPB and a single-dose oral tizanidine in patients undergoing elective thyroid surgery. Methods Sixty patients undergoing thyroidectomy were randomized into 3 groups. The control group (Group C, n  = 20) received BSCPB with 0.9% saline plus oral placebo. The superficial cervical group (Group SC, n  = 20) received BSCPB with 0.25% bupivacaine plus oral placebo. The superficial cervical and tizanidine group (Group SC + T, n  = 20) received BSCPB with 0.25% bupivacaine plus tizanidine 6 mg capsule. Surgical site pain scores, opioid consumption, rescue analgesia, posterior neck pain, headache, and opioid-related side effects were assessed for the first 24 h. Results Compared with Group C, rest and swallowing pain scores in Group SC and Group SC + T were statistically lower at all postoperative time points ( p