A Study To Compare The Analgesic Efficacy Of Dexamethasone And Dexmedetomidine As An Adjuvant To Bupivacaine For Bilateral Superficial Cervical Plexus Block In Patients Undergoing Thyroid Surgeries – A Randomised Clinical Trial

Abstract

BACKGROUND AND AIMS: Thyroid surgeries being one of the most common endocrine surgical procedures carried out throughout the world. Pain control is one of the many challenges faced by the perioperative physicians in post thyroid surgeries patients which when untreated proceeds to become chronic pain. The goal in the initial postoperative period is to provide good analgesia and better quality of recovery along with eliminating the side effects of systemic analgesics. Regional anaesthesia techniques have become a popular tool in achieving this goal. BSCPB is one of the simple and easy locoregional techniques used in managing pain in post thyroid surgery patients. This study aims at comparing the analgesic efficacy of dexmedetomidine and dexamethasone as an adjuvant with bupivacaine for BSCPB in patients undergoing thyroid surgeries. METHODOLOGY: • Written informed consent obtained. • Nil by mouth status confirmed. • IV access was secured 20 Gauge cannula. • Patients underwent thorough Pre-anaesthetic evaluation with detailed history, airway examination, systemic examination. Patient was explained about the BSCPB procedure and sensitized about Visual analogue scale. Routine blood investigations were done along with thyroid profile. • General anaesthesia was given. Before the incision, BSCPB was given with 10ml 0.5% bupivacaine either with 50mcg dexmedetomidine in Group A or 8mg dexamethasone in Group B. Patients were monitored for 24 hours for postoperative pain. RESULTS: • Age and gender were comparable and statistically insignificant. • Intraoperative hemodynamic parameters (SBP, DBP, MAP, HR) monitored at specific time intervals were significantly lower in Group A. • VAS scores were significantly better up to 8 hours in Group A. • The time taken for first analgesic dose request is significantly longer in Group A than Group B. • The total postoperative analgesic consumption was significantly lower in Group A than in Group B. • Group B had significantly lower incidence of postoperative nausea and vomiting. CONCLUSION: In conclusion, with all the above findings which are statistically significant, Dexmedetomidine performs better than dexamethasone as an adjuvant to bupivacaine for BSCPB for post operative analgesia in patients undergoing thyroid surgeries.