Efficacy of Adding Dexmedetomidine in Ultrasound-guided Intermediate Cervical Plexus Block for Thyroidectomy Surgery

Summary

The cervical plexus block (CPB) is one such block used to provide effective anesthesia and analgesia for surgery in the head and neck region. The cervical fascia was first described as a very strong and resisting structure, consisting of two layers, superficial and deep. But more recently classified the cervical fascia as superficial/subcutaneous and deep. The deep cervical fascia is further divided into three layers: (a) the superficial layer, which was also called the investing fascia but is now referred to as the masticator fascia, submandibular fascia or sternocleidomastoid (SCM)-trapezius fascia, (b) the middle layer, which is suggested as to be named as strap muscle fascia or visceral fascia; and (c) the deep layer or the 'prevertebral fascia'. Intermediate cervical plexus block (CPB) has been found to be very effective in procedures of neck such as thyroid surgeries and carotid endarterectomy. The duration of analgesia following the nerve blocks is a matter of concern as most of the blocks last for only a few hours. Interestingly, resurgence of the use of α2-agonists in combination with local anesthetics has dramatically improved the duration of action of these blocks. Dexmedetomidine is a potent α2 agonist and is now emerging as an adjuvant to regional anesthesia and analgesia. Little evidence is available supporting the usefulness of dexmedetomidine in bilateral intermediate CPB. Therefore, the current study will be conducted to compare the duration and effectiveness of post-thyroidectomy analgesia of bilateral intermediate CPB using 20 ml bupivacaine 0.25% (Group A) or 20 ml of bupivacaine 0.25% with 1 μg/kg dexmedetomidine (Group B).

Conditions

• Pain, Postoperative
• Cancer of Larynx

Interventions

DRUG

dexmedetomidine

adding dexmedetomidine as adjuvant with bupivacaine in Ultrasound-guided Intermediate Cervical Plexus Block for Thyroidectomy surgery.

DRUG

bupivacaine 0.25%

patients will receive bilateral Intermediate Cervical plexus block with 20 ml bupivacaine 0.25%.

PROCEDURE

Thyroidectomy Surgery

surgical removal of all or part of thyroid gland.

PROCEDURE

Ultrasound-guided intermediate Cervical Plexus Block Technique

the injection of local anesthetic in intermediate cervical plexus nerve block is made between the investing layer of the deep cervical fascia and the prevertebral fascia. Following negative aspiration, 1-2 mL of local anesthetic is injected to confirm the proper injection site.

Sponsors & Collaborators

• National Cancer Institute, Egypt

  lead OTHER

Principal Investigators

• Gehan M. Kamal, Prof. · National Cancer Institute, Anesthesia, Pain Relief and ICU Department

• Mohamed E. Hassan, Ass. Prof. · National Cancer Institute, Anesthesia, Pain Relief and ICU Department

• Mai M. Elrawas, Doctor · National Cancer Institute, Anesthesia, Pain Relief and ICU Department

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

60 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2023-04-01

Primary Completion

2023-10-01

Completion

2023-11-01

Countries

• Egypt

Study Locations