Which method is the most effective for reducing post-thyroidectomy pain: Bilateral superficial cervical block or wound infiltration? A prospective randomized, double-blind study

Aim: Thyroid surgery is a common operation, and pain is a significant problem in this operation. The aim of our study was to compare the postoperative analgesic efficacy of local anesthetic wound infiltration and bilateral superficial cervical block by measuring the 24-hour postoperative morphine requirements and postoperative pain intensity scores after thyroidectomy. Materials and methods: This study included 60 patients who were scheduled for a thyroidectomy. The patients were divided into two groups. Bilateral superficial cervical block with 20 ml 0.25% bupivacaine plus 1:200,000 epinephrine and wound infiltration with 0.9% 20 ml NaCl was performed in GroupA, while bilateral superficial cervical block with 20 ml 0.9% NaCl and wound infiltration with 0.25% 20 ml bupivacaine plus 1:200,000 epinephrine was performed in GroupB after skin closure.Postoperative pain was evaluated by Visual Analog Score. All patients were given diclofenac sodium at 12-hour intervals.If the patient's pain score was ≥4, 5 mg of morphine was given. The occurrence of nausea,vomiting and side effects was recorded. Results: The number of patients requiring morphine for 24 hours after surgery and the total postoperative morphine consumption for 24 hours were significantly lower in GroupB compared to the same values in GroupA (p=0.028 and p=0.01,respectively). The first analgesic requirement time was significantly longer in GroupB than it was in GroupA (1168±553.40 min vs 812±684.23 min, p=0.031).The postoperative VAS pain scores in GroupB were significantly lower than they were in GroupA at PACU admission(p=0.046), discharge from PACU (P=0.041), postoperative 8(p=0.001), 12(p=0.025) hours. Conclusions: We conclude that local anesthetic wound infiltration was more effective than bilateral superficial cervical block in reducing post-thyroidectomy pain.