Bilateral Superficial Cervical Plexus Block's Effectiveness as a Preemptive Analgesia in Thyroid Surgery under General Anesthesia

Abstract

Background: Thyroidectomy, though generally considered a low-pain procedure, often leads to mild to moderate postoperative discomfort, particularly during the first 24 hours. Conventional postoperative pain management relies on systemic analgesics like opioids, which carry the risk of side effects. Preemptive analgesia with regional blocks, such as the bilateral superficial cervical plexus block (BSCPB), has shown promise in reducing postoperative pain and opioid consumption in thyroid surgeries.
Methods: This prospective, randomized, controlled study was conducted at Sukh Sagar Medical College & Hospital, Jabalpur (M.P.), from January 2025 to May 2025. A total of 60 patients scheduled for elective thyroidectomy were randomly assigned to two groups: Group 1 received bilateral superficial cervical plexus block (BSCPB) before surgery, while Group 2 received standard general anesthesia without a block. The primary outcome was postoperative pain scores (VAS) measured at 0, 2, 4, 6, and 24 hours. Secondary outcomes included opioid consumption, postoperative complications, and surgery duration. Statistical analysis was performed using SPSS version 25, with a p-value < 0.05 considered significant.
Results: Group 1 demonstrated significantly lower pain scores at all time points compared to Group 2 (p < 0.05). Opioid consumption was also significantly lower in Group 1 (15 mg vs. 25 mg, p < 0.05). Additionally, the incidence of postoperative complications such as nausea, hematoma, hoarseness, and respiratory depression was reduced in Group 1. Surgery duration and intraoperative parameters did not show significant differences between the two groups.
Conclusion: The bilateral superficial cervical plexus block (BSCPB) administered as preemptive analgesia in thyroid surgery effectively reduces postoperative pain, opioid consumption, and complications. This study supports the use of BSCPB as a valuable addition to multimodal analgesia in thyroidectomy, improving patient outcomes and minimizing opioid-related side effects.