Archives of Head and Neck Surgery
http://www.archives.periodikos.com.br/article/doi/10.4322/ahns.2023.0016
Archives of Head and Neck Surgery
ORIGINAL ARTICLE THYROID DISEASES

Evaluation of intraoperative subcutaneous anesthetic infiltration for pain management in patients undergoing total thyroidectomy

Phamella Carlesse, Nathalia Cardoso, Tamara Harati, Bruna Lapichini, Daniel Herman Partezani, Leandro Luongo de Matos, Rogério Aparecido Dedivitis

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Abstract

Introduction: Postoperative pain is a common concern after thyroidectomy. Various medications are available for pain relief, and their efficacy often depends on the individual patient’s self-perception of pain. Objective: To evaluate the efficacy of intraoperative Bupivacaine application in reducing postoperative pain among patients undergoing total thyroidectomy. Materials and Methods: A prospective study was carried out with 153 female patients undergoing total thyroidectomy, with a randomization protocol for topical anesthetic infiltration. Postoperative pain intensity was self-reported by the patients using the Visual Analog Scale (VAS) at the 1st, 6th, and 24th postoperative hours. Results: Comparative analysis revealed that patients who did not receive anesthetic infiltration experienced, on average, higher pain levels during all three observation periods (1st and 6th hours, and 24th hour; p=0.0001 – repeated measures ANOVA multiple test) relative to those who received the anesthetic. Isolated observations showed that pain was significantly less severe at the 24th hour compared to the 6th hour (p=0.001 – repeated measures ANOVA test). Conclusion: Topical anesthetic infiltration proves to be an effective tool for managing post-thyroidectomy pain.

Keywords

pain; thyroid diseases; thyroidectomy; bupivacaine; anesthetic infiltration

References

1. Herbland A, Cantini O, Reynier P, Valat P, Jougon J, Arimone Y, Janvier G. The bilateral superficial cervical plexus block with 0.75% ropivacaine administered before or after surgery does not prevent postoperative pain after total thyroidectomy. Reg Anesth Pain Med. 2006;31(1):34-9. http://dx.doi.org/10.1016/j. rapm.2005.10.008. PMid:16418022.

2. Abdulla S, Eckhardt R, Netter U, Abdulla W. Efficacy of three IV non-opioidanalgesics on opioid consumption for postoperative pain relief after total thyroidectomy: a randomised, double-blind trial. Middle East J Anaesthesiol. 2012;21(4):543-52. PMid:23327027.

3. Egan RJ, Hopkins JC, Beamish AJ, Shah R, Edwards AG, Morgan JD. Randomized clinical trial of intraoperative superficial cervical plexus block versus incisional local anaesthesia in thyroid and parathyroid surgery. Br J Surg. 2013;100(13):1732-8. http://dx.doi.org/10.1002/bjs.9292. PMid:24227357.

4. Aunac S, Carlier M, Singelyn F, De Kock M. The analgesic efficacy of bilateral combined superficial and deep cervical plexus block administered before thyroid surgery under general anesthesia. Anesth Analg. 2002;95(3):746-50. http://dx.doi. org/10.1213/00000539-200209000-00039. PMid:12198064.

5. Mismar AA, Mahseeri MI, Al-Ghazawi MA, Obeidat FW, Albsoul MN, Al-Qudah MS, Albsoul NM. Wound infiltration with bupivacaine 0.5% with or without adrenaline does not decrease pain after thyroidectomy. Saudi Med J. 2017;38(10):994-9. http://dx.doi.org/10.15537/smj.2017.10.20294. PMid:28917062.

6. Karamanlioglu B, Turan A, Memis D, Kaya G, Ozata S, Ture M. Infiltration with ropivacaine plus lornoxicam reduces postoperative pain and opioid consumption. Can J Anaesth. 2005;52(10):1047-53. http://dx.doi.org/10.1007/BF03021603. PMid:16326674.

7. Chen Y, Nwaogu I, Chomsky-Higgins K, Gosnell JE, Seib C, Shen WT, Duh Q-Y, Suh I. Postoperative pain and opioid use after thyroid and parathyroid surgery. A pilot, prospective SMS-based survey. J Surg Res. 2019;240:236-40. http://dx.doi. org/10.1016/j.jss.2019.03.016. PMid:31004971.

8. Sellami M, Feki S, Triki Z, Zghal J, Zouche I, Hammami B, Charfeddine I, Chaari M, Ghorbel A. Bupivacaine wound infiltration reduces postoperative pain and analgesic requirement after thyroid surgery. Eur Arch Otorhinolaryngol. 2018;275(5):1265-

70. http://dx.doi.org/10.1007/s00405-018-4933-4. PMid:29536252.

9. Teksoz S, Arikan AE, Soylu S, Erbabacan SE, Ozcan M, Bukey Y. Bupivacaine application reduces post thyroidectomy pain: Cerrahpasa experience. Gland Surg. 2016;5(6):565-70. http://dx.doi.org/10.21037/gs.2016.12.04. PMid:28149801.

10. Li X, Yu L, Yang J, Tan H. Multimodal analgesia with ropivacaine wound infiltration and intravenous flurbiprofen axetil provides enhanced analgesic effects after radical thyroidectomy: a randomized controlled trial. BMC Anesthesiol. 2019;19(1):167. http://dx.doi.org/10.1186/s12871-019-0835-2. PMid:31470813.

11. Gozal Y, Shapira SC, Gozal D, Magora F. Bupivacaine wound infiltration in thyroid surgery reduces postoperative pain and opiod demand. Acta Anaesthesiol Scand. 1994;38(8):813-5. http://dx.doi.org/10.1111/j.1399-6576.1994.tb04010.x. PMid:7887103.

12. Bagul A, Taha R, Metcalfe MS, Brook NR, Nicholson ML. Pre-incision infiltration of local anesthetic reduces postoperative pain with no effects on bruising and wound cosmesis after thyroid surgery. Thyroid. 2005;15(11):1245-8. http://dx.doi. org/10.1089/thy.2005.15.1245. PMid:16356087.

13. Al-Mujadi H, A-Refai AR, Katzarov MG, Dehrab NA, Batra YK, Al-Qattan AR. A-Refai AR, Katzarov MG, Dehrab NA, Batra YK, Al-Qattan AR. Preemptive gabapentin reduces postoperative pain and opioid demand following thyroid surgery. Can J Anaesth. 2006;53(3):268-73. http://dx.doi.org/10.1007/BF03022214. PMid:16527792.


Submitted date:
07/08/2023

Accepted date:
09/07/2023

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