Analgesia Disorder, Local Anesthesia
Conditions
Keywords
cervical plexus block, thyroidectomy, opioid consumption
Brief summary
The investigators included prospectively 35 patients undergoing an intermediate cervical block under ultrasound (GP1) before a thyroidectomy ,compared to a group of 35 patients without a block (GP2).
Detailed description
The investigators performed prospective trial with 70 patients randomized in two groups each of 35: * Group 1 (GP1): bilateral echo-guided intermediate cervical plexus bloc (ICB) by 10 ml of isobaric Bupivacaine (0.25%). * Group 2 (GP2): control. Ten minutes after ICB, general anesthesia was realised. Total dose of Remifentanil is calculated upon awakening, the postoperative pain is determined by visual analog scale from 0 to 10 (VAS) statements to H0, H2, H4, H6, H12 and H24. Whenever VAS is greater than or equal to 4, a morphine titration was administered. Total dose consumption, side effects and satisfaction are noted at the end of protocol.
Interventions
PROCEDUREbilateral cervical plexus block
with a linear probe and after disinfection vascular neck axis are identified at first. At the cricoid cartilage we conducted an apical scan to locate the carotid bifurcation.at this level is carried out a lateral translation to the visibility of the deep cervical space below the sternocleidomastoidien muscle then a needle 50 is introduced in plane. we proceed in inundation of cervical space
Sponsors
University Hospital, Mahdia
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* candidate for thyroidectomy * reoperation l
Exclusion criteria
* no consent * BMI\> 34 * allergy to any of the products used * reoperation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| peroperative opioid consumption | opioid consumption during surgery | In addition to the standard monitoring , we associate that of narcosis (BIS, Covidien LLC.Mansfield, USA) whose level is maintained between 40 and 60, a monitoring of the capnia, maintained between 35 and 40mmHg, we associate an analyzer of gas.The maintenance of the anesthesia is provided by sevoflurane adjusted according to the values of the bi-spectral index. Remifentanil is administered by the electrical pump as a function of the variation in blood pressure and heart rate, which should not exceed 20% of their baseline values during the surgical procedure.All our patients were operated by the same team. Ten minutes before closure, each patient receives 1 g of paracetamol (Perfalgan®) and 50 to 100 mg of tramadol depending on his weight. The remifentanil syringe pump is stopped when the skin is closed and the total dose is calculated for each patient. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| postoperative opioid consumption | first 24 hours after surgery | the investigator proceed to evaluate pain at H0, H2, H4, H6, H12 and H24 postoperative hour. Each time the patient had a Visual analogic scale (VAS) greater than or equal to 40mm(from 0 to 100) a titration of 3 mg intravenous morphine every 5 minutes until VAS \<40mm . Total dose of morphine required was calculated 24 hours after surgery |
Countries
Tunisia
Outcome results
None listed