COMPARISON OF 0.5% ROPIVACAINE VERSUS 0.5% ROPIVACAINE WITH DEXMEDETOMIDINE IN BILATERAL SUPERFICIAL CERVICAL PLEXUS BLOCK FOR POSTOPERATIVE ANALGESIA IN THYROID SURGERY

Abstract

Background: Effective postoperative analgesia is important following thyroid surgery. Bilateral superficial cervical plexus block provides regional analgesia, but the duration of analgesia may be limited. Dexmedetomidine has been investigated as an adjuvant to local anaesthetics to prolong analgesic effects. This study compared 0.5% ropivacaine alone with 0.5% ropivacaine combined with dexmedetomidine for postoperative analgesia following thyroid surgery. Methods: A prospective, randomized, double-blind comparative study was conducted among 40 patients aged 18–65 years, classified as ASA I or II, undergoing elective thyroid surgery. Participants were randomly allocated into two equal groups of 20. Group R received bilateral superficial cervical plexus block with 0.5% ropivacaine (20 mL per side), while Group RD received 0.5% ropivacaine with dexmedetomidine 0.5 µg/kg (20 mL per side). The primary outcome was duration of postoperative analgesia. Secondary outcomes included VAS pain scores, time to first rescue analgesia, total analgesic consumption, rescue analgesic doses, haemodynamic parameters, sedation, patient satisfaction and adverse effects. Patients were followed for 24 hours postoperatively. Results: Mean duration of analgesia was significantly longer with ropivacaine plus dexmedetomidine than ropivacaine alone (14.6 ± 2.3 vs 6.8 ± 1.4 hours; p < 0.001). Time to first rescue analgesia was also prolonged (15.2 ± 2.4 vs 7.2 ± 1.5 hours; p < 0.001). Total postoperative analgesic consumption was lower (286.3 ± 46.9 vs 412.5 ± 58.4 mg; p < 0.001), as was the number of rescue doses (1.4 ± 0.5 vs 2.8 ± 0.6; p < 0.001). VAS scores were significantly lower at 8, 12 and 24 hours. Excellent satisfaction was higher with dexmedetomidine (65% vs 30%; p = 0.01). Postoperative haemodynamic parameters were comparable, although early sedation was greater with dexmedetomidine. Conclusion: Adding dexmedetomidine to 0.5% ropivacaine significantly prolonged analgesia, reduced postoperative analgesic requirements and improved pain control and patient satisfaction following thyroid surgery, with no significant difference in postoperative haemodynamic parameters.