scholarly journals Ultrasound-guided bilateral superficial cervical plexus block enhances the quality of recovery of uremia patients with secondary hyperparathyroidism following parathyroidectomy: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shenghong Hu ◽  
Teng Shu ◽  
Siqi Xu ◽  
Xia Ju ◽  
Shengbin Wang ◽  
...  
Keyword(s):  
Ultrasound Guided ◽  
Cervical Plexus ◽  
Total Consumption ◽  
Rescue Analgesia ◽  
Quality Of Recovery ◽  
Superficial Cervical Plexus Block ◽  
Vas Scores ◽  
Cervical Plexus Block ◽  
Plexus Block

Abstract Background Parathyroidectomy has been proposed as a method for reducing parathyroid hormone levels. We evaluated the effects of ultrasound-guided bilateral superficial cervical plexus block (BSCPB) on the quality of recovery of uremia patients with secondary hyperparathyroidism (SHPT) following parathyroidectomy. Methods Eighty-two uremia patients who underwent parathyroidectomy and exhibited SHPT were randomly allocated to the BSCPB group or the control group (CON group). The patients received ultrasound-guided BSCPB with 7.5 ml of ropivacaine 0.5% on each side (BSCPB group) or equal amount of 0.9% normal saline (CON group). The primary outcome of the Quality of Recovery-40(QoR-40) score was recorded on the day before surgery and postoperative day 1(POD1). Secondary outcomes including total consumption of remifentanil, time to first required rescue analgesia, number of patients requiring rescue analgesia, and total consumption of tramadol during the first 24 h after surgery were recorded. The occurrence of postoperative nausea or vomiting (PONV) and the visual analogue scale (VAS) scores were assessed and recorded. Results The scores on the pain and emotional state dimensions of the QoR-40 and the total QoR-40 score were higher in the BSCPB group than in the CON group on POD1 (P = 0.000). Compared with the CON group, the total consumption of remifentanil was significantly decreased in the BSCPB group (P = 0.000). The BSCPB group exhibited longer time to first required rescue analgesia (P = 0.018), fewer patients requiring rescue analgesia (P = 0.000), and lower postoperative total consumption of tramadol during the first 24 h after surgery (P = 0.000) than the CON group. The incidence of PONV was significantly lower in the BSCPB group than in the CON group (P = 0.013). The VAS scores in the BSCPB group were lower than those in the CON group at all time-points after surgery (P = 0.000). Conclusion Ultrasound-guided BSCPB with ropivacaine 0.5% can enhance the quality of recovery, postoperative analgesia, and reduce the incidence of PONV in uremia patients with SHPT following parathyroidectomy. Trial registration ChiCTR1900027185 . (Prospective registered). Initial registration date was 04/11/2019.

Ultrasound-Guided Bilateral Superficial Cervical Plexus Block Enhance the Quality of Recovery in Patients following Parathyroidectomy with Secondary Hyperparathyroidism

2021 ◽  
Author(s):  
Shenghong Hu ◽  
Teng Shu ◽  
Siqi Xu ◽  
Xia Ju ◽  
Shengbin Wang ◽  
...  
Keyword(s):  
Secondary Hyperparathyroidism ◽  
Ultrasound Guided ◽  
Total Consumption ◽  
Rescue Analgesia ◽  
Quality Of Recovery ◽  
Superficial Cervical Plexus Block ◽  
Vas Scores ◽  
Cervical Plexus Block ◽  
Plexus Block

Abstract Background:Parathyroidectomy has been proposed as method for reduction of PTH levels. We evaluated the effects of ultrasound-guided BSCPB on the quality of recovery following parathyroidectomy with secondary hyperparathyroidism.Methods:Eighty-two patients undergoing parathyroidectomy with secondary hyperparathyroidism were randomly allocated to BSCPB group (ultrasound-guided BSCPB with 7.5ml of ropivacaine 0.5% on each side) and the CON group(normal saline).The primary outcome of QoR-40 score was recorded.Secondary outcomes including total consumption of propofol and remifentanil,the numbers of patient requiring rescue analgesia, the time to first require rescue analgesia, the incidence of PONV, and the VAS scores were recorded.Results:The score in the pain and emotional state dimensions of QoR-40,and total QoR-40 score were higher in the BSCPB group than the CON group on POD1(P=0.000).Compared with the CON group,the total consumption of propofol and remifentanil was significantly decreased in the BSCPB group (P=0.000).Compared with the CON group, the time to first require rescue analgesia was longer(P=0.018),and numbers of patient requiring rescue analgesia were decreased in the BSCPB group ( P=0.000).The incidence of PONV was significantly lower in the BSCPB group than the CON group (P<0.05).The VAS scores in the BSCPB group were lower than the CON group in any time point after surgery (P=0.000). Conclusion: Ultrasound-guided BSCPB with ropivacaine 0.5% can enhance the quality of recovery, postoperative analgesia, and reduce the incidence of PONV following parathyroidectomy with secondary hyperparathyroidism.Trial registration: ChiCTR1900027185. (Prospective registered). Initial registration date was 04/11/2019.

scholarly journals Bilateral cervical plexus block for anterior cervical spine surgery: study protocol for a randomised placebo-controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Michael J. Mulcahy ◽  
Thananchayan Elalingam ◽  
Kevin Jang ◽  
Mario D’Souza ◽  
Matthew Tait
Keyword(s):  
Cervical Spine ◽  
Hospital Stay ◽  
Controlled Trial ◽  
Cervical Plexus ◽  
Cervical Spine Surgery ◽  
Quality Of Recovery ◽  
Anterior Cervical Spine Surgery ◽  
Cervical Plexus Block ◽  
Plexus Block

Abstract Background There has been increasing focus to improve the quality of recovery following anterior cervical spine surgery (ACSS). Postoperative pain and nausea are the most common reasons for prolonged hospital stay and readmission after ACSS. Superficial cervical plexus block (SCPB) provides site-specific analgesia with minimal side effects, thereby improving the quality of recovery. The aim of our study was to investigate the effect bilateral cervical plexus block has on postoperative recovery in patients undergoing ACSS. Methods The study is a pragmatic, multi-centre, blinded, parallel-group, randomised placebo-controlled trial. 136 eligible patients (68 in each group) undergoing ACSS will be included. Patients randomised to the intervention group will have a SCPB administered under ultrasound guidance with a local anaesthetic solution (0.2% ropivacaine, 15mL); patients randomised to the placebo group will be injected in an identical manner with a saline solution. The primary outcome is the 40-item quality of recovery questionnaire score at 24 h after surgery. In addition, comparisons between groups will be made for a 24-h opioid usage and length of hospital stay. Neck pain intensity will be quantified using the numeric rating scale at 1, 3, 6 and at 24 h postoperatively. Incidence of nausea, vomiting, dysphagia or hoarseness in the first 24 h after surgery will also be measured. Discussion By conducting a blinded placebo trial, we aim to control for the bias inherently associated with a tangible medical intervention and show the true treatment effect of SCPB in ACSS. A statistically significant result will indicate an overall improved quality of recovery for patients; alternatively, if no benefit is shown, this trial will provide evidence that this intervention is unnecessary. Trial registration ClinicalTrials.gov ACTRN12619000028101. Prospectively registered on 11 January 2019 with Australia New Zealand Clinical Trials Registry

scholarly journals Bilateral Cervical Plexus Block for Anterior Cervical Spine Surgery: Study Protocol for a Randomised Placebo-Controlled Trial

2021 ◽  
Author(s):  
Michael Mulcahy ◽  
Thananchayan Elalingam ◽  
Kevin Jang ◽  
Mario D'Souza ◽  
Matthew Tait
Keyword(s):  
Cervical Spine ◽  
Hospital Stay ◽  
Controlled Trial ◽  
Cervical Plexus ◽  
Cervical Spine Surgery ◽  
Quality Of Recovery ◽  
Anterior Cervical Spine Surgery ◽  
Cervical Plexus Block ◽  
Plexus Block

Abstract Background There has been increasing focus to improve the quality of recovery following anterior cervical spine surgery (ACSS). Postoperative pain and nausea are the most common reasons for prolonged hospital stay and readmission after ACSS. Superficial cervical plexus block (SCPB) provides site-specific analgesia with minimal side-effects, thereby improving quality of recovery. The aim of our study was to investigate the effect bilateral cervical plexus block has on post-operative recovery in patients undergoing ACSS. Methods The study is a pragmatic, multi-centre, blinded, parallel-group, randomised placebo-controlled trial. 136 eligible patients (68 in each group) undergoing ACSS will be included. Patients randomised to the intervention group will have a SCPB administered under ultrasound guidance with a local anaesthetic solution (0.2% ropivacaine, 15mL); patients randomised to the placebo group will be injected in an identical manner with a saline solution. The primary outcome is the 40-item quality of recovery questionnaire score at 24 hours after surgery. In addition, comparisons between groups will be made for 24-hour opioid usage and length of hospital stay. Neck pain intensity will be quantified using the numeric rating scale at 1, 3, 6 and at 24 hours post-operatively. Incidence of nausea, vomiting, dysphagia or hoarseness in the first 24 hours after surgery will also be measured. Discussion By conducting a blinded placebo trial, we aim to control for the bias inherently associated with a tangible medical intervention and show the true treatment effect of SCPB in ACSS. A statistically significant result will indicate an overall improved quality of recovery for patients; alternatively, if no benefit is shown, this trial will provide evidence that this intervention is unnecessary. Trial registration Prospectively registered with the Australia New Zealand Clinical Trials Registry: ACTRN12619000028101. Registration date: 11/01/19.

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