Local bupivacaine for postoperative pain management in thyroidectomized patients: a prospective and controlled clinical study
Ersin Gürkan Dumlu1, Mehmet Tokaç1, Haydar Öcal1, Doğukan Durak1, Halil Kara2, Mehmet Kılıç3, Abdussamed Yalçın3
1Clinic of General Surgery, Atatürk Training and Research Hospital, Ankara, Turkey
2Department of Pharmacology, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
3Department of General Surgery, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
Keywords: Bupivacaine, postoperative pain, thyroidectomy
Objective: We aimed to evaluate the effect of bupivacaine and to compare the routes of administration of bupivacaine in the management of postoperative incision site pain after thyroidectomy.
Material and Methods: Consecutive patients who were planned thyroidectomy surgery were randomized into three groups of 30 patients each: Group 1 (control group): standard thyroidectomy surgery without additional intervention; Group 2 (paratracheal infiltration with bupivacaine): following thyroidectomy, 0.25% bupivacaine was applied on the surgical area; Group 3 (subcutaneous infiltration with bupivacaine): following thyroidectomy, 0.25% bupivacaine was injected into the cutaneous, subcutaneous and fascia of the surgical area. Postoperative pain of was evaluated by a visual analog scale (VAS) at 1st, 4th, and 12th hours after thyroidectomy. Total daily need for additional analgesia was recorded.
Results: The mean age of 90 patients was 44.37±13.42 years, and the female:male ratio was 62:28. There was no difference between study groups in terms of age, thyroid volume, TSH and T4 levels. VAS score of patients in paratracheal infiltration bupivacaine group was significantly lower than control group patients at 1st, 4th and 12th hours following the thyroidectomy operation (p=0.030, p=0.033, p=0.039, respectively). The need for analgesics was significantly lower in both paratracheal infiltration and subcutaneous infiltration groups than control group (86.7%, 83.0%, and 73.3%, respectively, p=0.049).
Conclusions: In conclusion, intraoperative local bupivacaine application is effective in decreasing postoperative pain of thyroidectomized patients.
Ethics committee approval was received for this study from the ethics committee of Yıldırım Beyazıt University School of Medicine.
Written informed consent was obtained from patients who participated in this study.
Concept – E.G.D., M.T.; Design – E.G.D., H.K.; Supervision – A.Y., M.K.; Resources – D.D.; Materials – D.D., H.Ö.; Data Collection and/or Processing – D.D.; Analysis and/or Interpretation – E.G.D., M.T.; Literature Search – E.G.D., M.T.; Writing Manuscript – E.G.D.; Critical Review – M.K., A.Y.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.