• Alexandre Herbland, Olivier Cantini, Patrick Reynier, Philippe Valat, Jacques Jougon, Yannick Arimone, and Gerard Janvier.
• Department of Anesthesiology and Intensive Care 2, Centre Hospitalier Universitaire (CHU) de Bordeaux. Université Bordeaux, 2 Victor Segalen, Bordeaux, France. alexandre.herbland@wanadoo.fr
• Reg Anesth Pain Med. 2006 Jan 1;31(1):34-9.

Background And ObjectivesPatients undergoing thyroid surgery need postoperative pain management. Bilateral superficial cervical plexus block by administration of 0.25% bupivacaine with 1:200000 epinephrine at the end of surgery has been shown to improve postoperative analgesia. The objective of this study was to assess the analgesic efficacy in the first 36 postoperative hours after total thyroidectomy of bilateral superficial cervical plexus block with 0.75% ropivacaine administered before the incision or on completion of the surgical procedure.MethodsWe performed a prospective double-blinded, randomized controlled trial that compared 3 parallel groups: the CONT group did not receive any block, the PRE group received bilateral superficial cervical plexus block before surgery while under general anesthesia, and the POST group received bilateral superficial cervical plexus block after surgery while under general anesthesia. The study included 111 patients (37 in each group). Postoperative pain was assessed every 4 hours by use of a 0 to 10 numeric rating scale. All patients received paracetamol every 6 hours. Morphine was administered following a standardized protocol if the numeric rating scale was 4 or higher. The main outcome variables were the proportion of patients given morphine during the 36 hours period, pain intensity scores, and morphine consumption.ResultsNo intergroup differences were observed in terms of percentage of patients who required morphine, morphine delivery, pain scores, and intraoperative opioid consumption.ConclusionsBilateral superficial cervical plexus block with 0.75% ropivacaine administered before or after surgery does not improve postoperative analgesia after total thyroidectomy.

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