Comparative Efficacy of Parenteral and Perineural Dexmedetomidine with 0.25% Ropivacaine for Post-Thyroidectomy Analgesia Using Bilateral Superficial Cervical Plexus Block: A Randomized Trial (Code-T0217)

Introduction: Effective post-thyroidectomy pain management is crucial for patient recovery and comfort. Bilateral superficial cervical plexus block (BSCPB) with ropivacaine is widely used, and dexmedetomidine, an α2-adrenergic agonist, has shown potential in enhancing analgesic effects. However, the optimal route of dexmedetomidine administration—parenteral or perineural—remains unclear. This study compares the efficacy of these two approaches in prolonging analgesia and improving postoperative outcomes.

Aim and Objectives:

Aim:

The aim of study to compare of efficacy of parenteral and perineural dexmedetomidine with 0.25% ropivacaine for post thyroidectomy analgesia using bilateral superficial cervical plexus block.

Objectives:

Primary objectives

• To evaluate the duration of post operative analgesia ( fromextubation to given 1^st dose of rescue analgesia )

Secondary objectives

1. To assess the number of doses of rescue analgesic requirement in 24hours.
2. To compare of postoperative visual analog score among study groups.
3. Hemodynamic changes
4. Ramsay sedation score
5. Side effects/complications if any .

Methods: A randomized comparative trial was conducted on patients undergoing thyroidectomy. Participants were divided into two groups: Group P (parenteral dexmedetomidine with 0.25% ropivacaine) and Group N (perineural dexmedetomidine with 0.25% ropivacaine) for BSCPB. Pain scores (VAS), total analgesic consumption, hemodynamic parameters, and adverse effects were recorded over 24 hours. Statistical analysis was performed using SPSS, with p<0.05 considered significant.

Results: Perineural dexmedetomidine significantly prolonged analgesia duration and reduced postoperative opioid consumption compared to the parenteral route (p<0.001). Pain scores were lower in Group N at all time points. Hemodynamic stability was comparable in both groups, with no significant adverse effects.

Conclusion: Perineural dexmedetomidine enhances the analgesic effect of BSCPB more effectively than parenteral administration, providing longer pain relief and reducing opioid need in post-thyroidectomy patients.

Keywords: Dexmedetomidine, ropivacaine, thyroidectomy, analgesia, cervical plexus block, postoperative pain.