Journal of Pain Research (Mar 2023)

Analgesic Efficacy of an Ultrasound-Guided Transversus Thoracis Plane Block Combined with an Intermediate Cervical Plexus Block on Postoperative Pain Relief After Trans-Areolar Endoscopic Thyroidectomy: A Single Center Prospective Randomized Controlled Study

  • Zhong R,
  • Zou Y,
  • Bao S,
  • Chen Y,
  • Huang G,
  • Wang L,
  • Chen L,
  • Zhong M,
  • Liang W

Journal volume & issue
Vol. Volume 16
pp. 1059 – 1067

Abstract

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Ruipeng Zhong,1,2,* Yun Zou,3,* ShuZhen Bao,2 YiJian Chen,2 Guiming Huang,2 Lifeng Wang,3 Li Chen,3 Maolin Zhong,3 Weidong Liang3 1Gannan Medical University, Ganzhou, People’s Republic of China; 2Department of Anesthesiology,Ganzhou People’s Hospital, Ganzhou, People’s Republic of China; 3Anesthesia Surgery Center, the First Affiliated Hospital of Gannan Medical University, Ganzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Weidong Liang, Anesthesia Surgery Center, the First Affiliated Hospital of Gannan Medical University, No. 128, Jinling West Road, Economic and Technological Development Zone, Ganzhou, Jiangxi Province, 341000, People’s Republic of China, Tel +86 15970122157, Email [email protected]: This study aimed to investigate the analgesic effect of ultrasound-guided transversus thoracis plane block (TTPB) combined with intermediate cervical plexus block (ICPB) in the early postoperative period after trans-areolar endoscopic thyroidectomy.Patients and Methods: A total of 62 female patients undergoing trans-areolar endoscopic thyroidectomy were randomly classified to the TTPB combined with ICPB group with ropivacaine (block group) or superficial cervical plexus block group (control group). The primary outcome measures were resting visual analogue scale (VAS) in the chest area at 6 h after surgery. The secondary outcome measures included chest resting and movement VAS score, neck resting and movement VAS score within 24 h after surgery, intraoperative remifentanil consumption, postoperative analgesia rate and analgesic requirements and patient satisfaction score for pain management at discharge.Results: Compared with the control group, the block group at rest showed consistently lower VAS scores in the chest area at 6 and 12 h after operation; the block group at rest showed lower VAS scores in the neck at 6, 12 and 24 h after operation. Regarding movement, the VAS scores of the chest and neck area at 2, 6, 12 and 24 h after the operation were lower in the block group than in the control group. The consumption of remifentanil, rate of postoperative analgesic requirements, and consumption of postoperative rescue analgesia in the block group were lower than those in the control group. Satisfaction with pain treatment at discharge was higher in the block group than in the control group.Conclusion: Ultrasound-guided TTPB combined with ICPB provides good analgesic effect in the early postoperative period after trans-areola endoscopic thyroidectomy.Keywords: regional anesthesia, nerve block, analgesia, trans-areolar endoscopic thyroidectomy

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