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1556151 
Journal Article 
Comparison of analgesic efficacy between bilateral superficial and combined (superficial and deep) cervical plexus block administered before thyroid surgery 
Suh, YJ; Kim, YS; In, JH; Joo, JD; Jeon, YS; Kim, HK 
2009 
Yes 
European Journal of Anaesthesiology
ISSN: 0265-0215
EISSN: 1365-2346 
26 
12 
1043-1047 
English 
19571762 
WOS:000208070200011 
BACKGROUND AND OBJECTIVE: To evaluate the analgesic efficacy of bilateral superficial cervical plexus block and combined superficial and deep cervical plexus block for incision pain, headache and posterior neck pain after thyroidectomy.

METHOD: Ninety patients were divided into a control group (group C, n = 30), a bilateral superficial cervical plexus group (group S, n = 30) and a bilateral combined superficial and deep cervical plexus block group (group CO, n = 30). Before general anaesthesia, we performed bilateral superficial cervical plexus block (18 ml) and combined superficial (14 ml) and deep (4 ml) cervical plexus block with 0.25% bupivacaine. Anaesthesia was maintained with propofol-remifentanil-N2O-O2.

RESULTS: The average concentration of remifentanil was significantly reduced in group S compared with group C and group CO (1.1 +/- 0.3, 1.8 +/- 0.4, 1.8 +/- 0.7 ng ml, respectively; P < 0.05). The incision pain at rest and on swallowing were significantly reduced at 0, 2 and 4 h in group S compared with group C (P < 0.05). Headache showed a tendency to be reduced in group S and group CO, but the posterior neck pain was not different among the three groups. After surgery, the opioid and nonopioid requirement was significantly reduced in group S (P < 0.05). There were fewer side effects and greater patients' satisfaction in group S.

CONCLUSION: Superficial cervical plexus block is a more effective technique than combined superficial and deep cervical plexus block to reduce the pain during and immediately after thyroidectomy.