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European Archives of Oto-Rhino-Laryngology

, Volume 275, Issue 5, pp 1265–1270 | Cite as

Bupivacaine wound infiltration reduces postoperative pain and analgesic requirement after thyroid surgery

  • Moncef Sellami
  • Sarhan Feki
  • Zied Triki
  • Jamil Zghal
  • Imen Zouche
  • Boutheina Hammami
  • Ilhem Charfeddine
  • Mohamed Chaari
  • Abdelmonem Ghorbel
Head and Neck
  • 174 Downloads

Abstract

Background and objective

We conducted a prospective double-blind randomized study assessing bupivacaine end-of-surgery wound infiltration for pain relief in thyroid surgery.

Methods

Patients were randomly divided into two groups: Group S, local wound infiltration with saline solution; Group B, bupivacaine 0.5% was administered. Pain perception was measured using visual analogue scale (VAS) during post-anaesthetic care unit (PACU) stay every 10 min and during the 24 postoperative hours admission at 2, 4, 6, 12, and 24 h after surgery. The total consumption of analgesics (morphine and nefopam) was recorded.

Results

Sixty patients were studied. The VAS scores were significantly lower in the bupivacaine administered group in the post-anaesthetic care unit (PACU) at 0, 10, 20, 30, 40, 50 and 60 min, and during the hospital stay at hours 6, 12, 18 and 24. The number of patients who required postoperative opioid rescue was significantly lower in group B. No patient in group B developed neurological or cardiological complications after infiltration.

Conclusion

Bupivacaine application is effective in decreasing postoperative pain and analgesic requirement during the hospital stay for patients with thyroidectomy.

Keywords

Bupivacaine Pain Analgesia Thyroidectomy 

Notes

Compliance with ethical standards

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Research involving human participants and/or animals

The study was approved by the appropriate institutional ethics committee and was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

References

  1. 1.
    Senapathi TGA, Widnyana IMG, Aribawa IGNM et al (2017) Ultrasound-guided bilateral superficial cervical plexus block is more effective than landmark technique for reducing pain from thyroidectomy. J Pain Res 10:1619–1622.  https://doi.org/10.2147/JPR.S138222 CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Teksoz S, Arikan AE, Soylu S et al (2016) Bupivacaine application reduces post thyroidectomy pain: Cerrahpasa experience. Gland Surg 5:565–570.  https://doi.org/10.21037/gs.2016.12.04 CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Dumlu EG, Tokaç M, Öcal H et al (2015) Local bupivacaine for postoperative pain management in thyroidectomized patients: a prospective and controlled clinical study. Turk J Surg/Ulusal Cerrahi Derg 32:173–177.  https://doi.org/10.5152/UCD.2015.3138 Google Scholar
  4. 4.
    Hema VR, Ramadas KT, Biji KP et al (2017) A Prospective, observational study to evaluate the role of gabapentin as preventive analgesic in thyroidectomy under general anesthesia. Anesth Essays Res 11:718–723.  https://doi.org/10.4103/aer.AER_250_16 CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Gürkan Y, Taş Z, Toker K, Solak M (2015) Ultrasound guided bilateral cervical plexus block reduces postoperative opioid consumption following thyroid surgery. J Clin Monit Comput 29:579–584.  https://doi.org/10.1007/s10877-014-9635-x CrossRefPubMedGoogle Scholar
  6. 6.
    Mismar AA, Mahseeri MI, Al-Ghazawi MA et al (2017) Wound infiltration with bupivacaine 0.5% with or without adrenaline does not decrease pain after thyroidectomy. Saudi Med J 38:994–999.  https://doi.org/10.15537/smj.2017.10.20294 CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Chapman PJ (1987) Review: bupivacaine–a long-acting local anaesthetic. Aust Dent J 32:288–291CrossRefPubMedGoogle Scholar
  8. 8.
    Ayman M, Materazzi G, Bericotti M et al (2012) Bupivacaine 0.5% versus ropivacaine 0.75% wound infiltration to decrease postoperative pain in total thyroidectomy, a prospective controlled study. Minerva Chir 67:511–516PubMedGoogle Scholar
  9. 9.
    Mallampati SR, Gatt SP, Gugino LD et al (1985) A clinical sign to predict difficult tracheal intubation: a prospective study. Can Anaesth Soc J 32:429–434CrossRefPubMedGoogle Scholar
  10. 10.
    Gozal Y, Shapira SC, Gozal D, Magora F (1994) Bupivacaine wound infiltration in thyroid surgery reduces postoperative pain and opioid demand. Acta Anaesthesiol Scand 38:813–815CrossRefPubMedGoogle Scholar
  11. 11.
    Arora N, Dhar P, Fahey TJ (2006) Seminars: local and regional anesthesia for thyroid surgery. J Surg Oncol 94:708–713.  https://doi.org/10.1002/jso.20694 CrossRefPubMedGoogle Scholar
  12. 12.
    Qureshi RM, Khan FA (2016) Effects of bupivacaine infiltration on postoperative tramadol consumption in elective day care unilateral inguinal hernia repair. JPMA J Pak Med Assoc 66:256–259PubMedGoogle Scholar
  13. 13.
    Hosseini H, Abrisham SMJ, Jomeh H et al (2012) The comparison of intraarticular morphine-bupivacaine and tramadol-bupivacaine in postoperative analgesia after arthroscopic anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 20:1839–1844.  https://doi.org/10.1007/s00167-011-1791-7 CrossRefGoogle Scholar
  14. 14.
    Admani B, Essajee F (2010) Successful resuscitation of a three month old child with intralipid infusion, presumed to have bupivacaine induced seizures and cardiovascular complications: case report. East Afr Med J 87:354–356PubMedGoogle Scholar
  15. 15.
    Block L, Jörneberg P, Björklund U et al (2013) Ultralow concentrations of bupivacaine exert anti-inflammatory effects on inflammation-reactive astrocytes. Eur J Neurosci 38:3669–3678.  https://doi.org/10.1111/ejn.12364 CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Foley PL, Ulery BD, Kan HM et al (2013) A chitosan thermogel for delivery of ropivacaine in regional musculoskeletal anesthesia. Biomaterials 34:2539–2546.  https://doi.org/10.1016/j.biomaterials.2012.12.035 CrossRefPubMedGoogle Scholar
  17. 17.
    Tam K-W, Chen S-Y, Huang T-W et al (2015) Effect of wound infiltration with ropivacaine or bupivacaine analgesia in breast cancer surgery: a meta-analysis of randomized controlled trials. Int J Surg Lond Engl 22:79–85.  https://doi.org/10.1016/j.ijsu.2015.07.715 CrossRefGoogle Scholar
  18. 18.
    Bagul A, Taha R, Metcalfe MS et al (2005) Pre-incision infiltration of local anesthetic reduces postoperative pain with no effects on bruising and wound cosmesis after thyroid surgery. Thyroid Off J Am Thyroid Assoc 15:1245–1248.  https://doi.org/10.1089/thy.2005.15.1245 CrossRefGoogle Scholar
  19. 19.
    Egan RJ, Hopkins JC, Beamish AJ et al (2013) Randomized clinical trial of intraoperative superficial cervical plexus block versus incisional local anaesthesia in thyroid and parathyroid surgery. Br J Surg 100:1732–1738.  https://doi.org/10.1002/bjs.9292 CrossRefPubMedGoogle Scholar
  20. 20.
    Cai H-D, Lin C-Z, Yu C-X, Lin X-Z (2012) Bilateral superficial cervical plexus block reduces postoperative nausea and vomiting and early postoperative pain after thyroidectomy. J Int Med Res 40:1390–1398.  https://doi.org/10.1177/147323001204000417 CrossRefPubMedGoogle Scholar
  21. 21.
    Andrieu G, Amrouni H, Robin E et al (2007) Analgesic efficacy of bilateral superficial cervical plexus block administered before thyroid surgery under general anaesthesia. Br J Anaesth 99:561–566.  https://doi.org/10.1093/bja/aem230 CrossRefPubMedGoogle Scholar
  22. 22.
    Eti Z, Irmak P, Gulluoglu BM et al (2006) Does bilateral superficial cervical plexus block decrease analgesic requirement after thyroid surgery? Anesth Analg 102:1174–1176.  https://doi.org/10.1213/01.ane.0000202383.51830.c4 CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Otorhinolaryngology, Head and Neck SurgeryHabib Bourguiba University HospitalSfaxTunisia
  2. 2.Department of AnesthesiaHabib Bourguiba University HospitalSfaxTunisia

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