Chronic Pain, Thyroidectomy
Conditions
Keywords
Ketamine, Thyroidectomy, Cervical block
Brief summary
The goal of our work is to to compare the effect of preemptive Ketamine administration versus superficial cervical plexus block on the incidence of postoperative neuropathic pain in patients undergoing thyroidectomy
Interventions
DRUGKetamine perfusion
Intravenous ketamine 0.25 mg/kg bolus followed by a 2 µg/kg/min infusion
PROCEDURESuperficial cervical plexus block
Bilateral ultrasound-guided superficial cervical plexus block after induction(Ropivacaine 0.2% Ropivacaine 0.2%, with a volume of 10 mL administered to each side) was performed for patients of this group
Sponsors
University Tunis El Manar
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Adults aged 18 to 80 years * Scheduled for thyroidectomy under general anesthesia. * American Society of Anesthesiologists (ASA) physical status I-III. * Able to understand the study procedures and provide written informed consent
Exclusion criteria
* Known allergy to ketamine or local anesthetics * Severe renal impairment with estimated Glomerular Filtration Rate (eGFR) under 30 mL/min * History of neurological disorders * History of psychiatric illness * History of severe cardiac disease (NYHA III-IV) or serious arrhythmias * Pregnancy or breastfeeding * Morbid obesity (BMI \> 40 kg/m²) * Cognitive or communication impairment * Refusal to participate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The incidence of chronic neuropathic pain at three months | three months after thyroidectomy | The incidence of chronic neuropathic pain at three months after thyroidectomy, as determined by the DN4 questionnaire. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Twenty-four hour postoperative rescue analgesia requirements | within the first 24 hours after the thyroidectomy. | The total amount of extra, on-demand pain medication a patient needed in the first 24 hours after their surgery was completed. |
| Intraoperative sufentanil consumption | During the intraoperative period | The secondary endpoints included intraoperative sufentanil consumption and reinjection requirements. |
| Postoperative sleep quality | During the first 24 postoperative hours. | Sleep quality was assessed 24 hours postoperatively to accurately reflect the effects of analgesia, utilizing the Athens Insomnia Scale (AIS) score. |
| Incidence of postoperative nausea and vomiting (PONV) within 24 hours post-surgery | 24 hours after surgery. | Occurrence of at least one episode of nausea or vomiting within the first 24 hours after surgery. |
| The Observer's Assessment of Alertness/Sedation (OAA/S) within a 2-hour timeframe following thyroidectomy. | 2-hour timeframe following thyroidectomy | Patients underwent Observer's Assessment of Alertness/Sedation (OAA/S) assessment within a 2-hour timeframe following thyroidectomy, before being cleared for PACU discharge. |
Countries
Tunisia
Outcome results
None listed