After thyroidectomy, the intravenous infusion of dexmedetomidine (DEX) can reduce pain on the order of superficial cervical plexus blockade (SCPB), according to a study recently published in The Clinical Journal of Pain.
This randomized controlled study included 90 participants (age 18-65 years) scheduled to undergo elective thyroidectomy between August and December 2019. Participants were randomly assigned to 3 groups. Group D (n=30) received intravenous DEX administered at 1 µg/kg over 10 minutes, followed by induction and endotracheal intubation, then by a continuous 0.4 µg/kg/h infusion until a half-hour before completion of surgery. Group B (n=30) received a bilateral SCPB guided by ultrasound, as well as 10 mL of 0.375% ropivacaine injected on either side, then by anesthesia and endotracheal intubation. In Group C, intravenous saline was injected at the same rate and dosage as Group D before surgery.
Visual analog scale scores, perioperative status, participant satisfaction, and complications were included as primary and secondary outcomes.
Compared with Group C, Groups D and B experienced significantly lower levels of movement-evoked pain (Group D, 4.1±1.2; Group B, 4.2±1.3; Group C, 5.2±1.9; P =.012) 24 hours after extubation and pain at rest 1 hour after extubation (Group D, 2.0±0.9; Group B, 1.9±0.7; Group C, 2.6±1.5; P =.018). Satisfaction was also higher in Groups D (yes/no: 27/3) and B (24/6) compared with Group C (17/13; P =.009). Groups D and B did not differ significantly in terms of movement-evoked pain, satisfaction, or pain at rest.
Limitations to this study include a lack of blinding and a lack of certain drugs, which precluded multimodal analgesia.
“Intravenous infusion of DEX is therefore well worth considering [to] improve the efficiency of anesthesia and minimize the workload of anesthesiologists while meeting the needs of patients,” the study authors concluded.
Xing J, Wu R, Liang L, Fang H, Chen L, Luo C. Comparison of the analgesic effects of intravenous infusion of dexmedetomidine versus bilateral superficial cervical plexus block after thyroidectomy: a randomized controlled trial. Clin J Pain. 2021 Aug 1;37(8):623-628.