Gland and Hormone Related Diseases

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Thyroid Diseases

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Thyroid Neoplasms

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Parathyroid Diseases

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Anesthetics, General

bilateral superficial cervical plexus block with 0.25% bupivacaine 8 ml each (total 0.25% bupivacaine 16 mg)

General anesthesia with endotracheal intubation under total intravenous anesthesia (TIVA)

Bilateral superficial cervical plexus block with 0.25% bupivacaine 8 ml each (total 16 ml)

Dexmedetomidine 0.5 ug/kg infusion in 10 min then 0.5 ug/kg/h, Propofol infusion

Dexmedetomidine plus propofol infusion

local infiltration analgesia with 2%lidocaine with adrenaline 5 ug/ml 10 ml

Local infiltraion analgesia

Induction with Propofol and intubation with cisatracurium

General anesthesia with endotracheal tube

Suwimon Tangwiwat, MD

Suwimon Tangwiwat, M.D

To compare efficacy and safety between bilateral superficial cervical plexus block combined with intravenous sedation (RA group) and general anesthesia (GA group) for thyroid and parathyroid operations. This study evaluates postoperative numerical pain score and systemic opioid requirement within 24 hours.

According to literature review, there is limit information about efficacy and safety of thyroid and parathyroid operations under bilateral superficial cervical plexus block combined with intravenous sedation without general anesthesia. General anesthesia is commonly used for neck operations because it is easy to perform. However in high cardiovascular or pulmonary risk patients such as end stage renal disease (ESRD) patients, regional anesthesia such as superficial cervical plexus block combined with intravenous sedation have become an alternative technique for neck operations.

This study evaluate whether regional anesthesia (RA) technique can be the alternative technique for thyroid/parathyroid surgery compare to conventional technique (GA).

Bilateral Superficial Cervical Plexus Block in Thyroid/Parathyroid Surgery

Bilateral Superficial Cervical Plexus Block Combined With Intravenous Sedation Versus General Anesthesia in Selected Patients for Thyroid/Parathyroid Surgery ; a Prospective Randomized Control Trial

Inable operation due to pain or movement, need to convert from RA toGA

Numerical rating scale 0-10 (0=no pain, 10= worst pain imaginable)

Percentage of patients present with hoarseness, dyspnea, local anaesthetic systemic toxicity

satisfaction scale score 0-10 ( 0= highly unsatisfied, 10= highly satisfied)

Mahidol University

Assistant professor, Department of Anesthesiology

Endocrine Gland Neoplasms

Head and Neck Neoplasms

Ropivacaine

Bilateral superficial cervical plexus block with 0.525% ropivacaine 20ml

Bilateral superficial cervical plexus block

Procedure: Bilateral superficial cervical plexus block with normal saline 20ml

placebo

Procedure: Local anesthetic infiltration at incision site with 0.525% ropivacaine 20ml

Control group

This study was designed to investigate the analgesic effect of bilateral superficial cervical plexus block in patients undergoing robot-assisted endoscopic thyroidectomy. The investigators hypothesized that bilateral superficial cervical plexus blockade would reduce the patient's pain score by more than 10 (on a VAS scale of 0\~100) compared to a placebo group and control group.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Bilateral Superficial Cervical Plexus Block in Thyroid/Parathyroid Surgery	NCT04051099	Benign Tumor of... Hyperparathyroi...	Bilateral super... Dexmedetomidine... Local infiltrai... General anesthe...	18 Years -	Mahidol University
Analgesic Efficacy of Bilateral Superficial Cervical Plexus Block in Robot-assisted Endoscopic Thyroidectomy Using a Transaxillary Approach	NCT01325857	Thyroid Cancer	Bilateral super... placebo Control group	20 Years -	Yonsei University
Bilateral Superficial Cervical Plexus Block in Thyroid/Parathyroid Surgery	NCT04051099	Benign Tumor of... Hyperparathyroi...	Bilateral super... Dexmedetomidine... Local infiltrai... General anesthe...	18 Years -	Mahidol University
Analgesic Efficacy of Bilateral Superficial Cervical Plexus Block in Robot-assisted Endoscopic Thyroidectomy Using a Transaxillary Approach	NCT01325857	Thyroid Cancer	Bilateral super... placebo Control group	20 Years -	Yonsei University

Spots Global Cancer Trial Database for bilateral superficial cervical plexus block