Abstract:
BACKGROUND AND AIMS:
Thyroid surgeries being one of the most common endocrine surgical procedures
carried out throughout the world. Pain control is one of the many challenges faced
by the perioperative physicians in post thyroid surgeries patients which when
untreated proceeds to become chronic pain. The goal in the initial postoperative
period is to provide good analgesia and better quality of recovery along with
eliminating the side effects of systemic analgesics. Regional anaesthesia
techniques have become a popular tool in achieving this goal. BSCPB is one of
the simple and easy locoregional techniques used in managing pain in post
thyroid surgery patients.
This study aims at comparing the analgesic efficacy of dexmedetomidine and
dexamethasone as an adjuvant with bupivacaine for BSCPB in patients
undergoing thyroid surgeries.
METHODOLOGY:
• Written informed consent obtained.
• Nil by mouth status confirmed.
• IV access was secured 20 Gauge cannula.
• Patients underwent thorough Pre-anaesthetic evaluation with detailed
history, airway examination, systemic examination. Patient was explained
about the BSCPB procedure and sensitized about Visual analogue scale.
Routine blood investigations were done along with thyroid profile. • General anaesthesia was given. Before the incision, BSCPB was given with
10ml 0.5% bupivacaine either with 50mcg dexmedetomidine in Group A
or 8mg dexamethasone in Group B. Patients were monitored for 24 hours
for postoperative pain.
RESULTS:
• Age and gender were comparable and statistically insignificant.
• Intraoperative hemodynamic parameters (SBP, DBP, MAP, HR) monitored
at specific time intervals were significantly lower in Group A.
• VAS scores were significantly better up to 8 hours in Group A.
• The time taken for first analgesic dose request is significantly longer in
Group A than Group B.
• The total postoperative analgesic consumption was significantly lower in
Group A than in Group B.
• Group B had significantly lower incidence of postoperative nausea and
vomiting.
CONCLUSION:
In conclusion, with all the above findings which are statistically significant,
Dexmedetomidine performs better than dexamethasone as an adjuvant to
bupivacaine for BSCPB for post operative analgesia in patients undergoing
thyroid surgeries.
