Anesthesiology
June 10, 2026 · via Europe PMC
Superficial Cervical Plexus Block and Quality of Recovery after Thyroidectomy: A Randomized Clinical Trial.
Jegarl AM, Martin M, Cormier NR, +10 more, Hyman JB.
AI summary — for doctors, generated from the abstract only
Adding a bilateral superficial cervical plexus block to a multimodal thyroidectomy pathway did not improve quality of recovery.
What was studied
A single-centre double-blind placebo-controlled RCT of 160 thyroidectomy patients randomised to bupivacaine 0.25% blocks (n=78) or saline (n=82), all receiving multimodal analgesia.
Key findings
- Day-1 QoR-40 was 174 vs 173 (adjusted difference 0.91, 95% CI -3.57 to 5.40)
- No significant differences in rescue opioid, nausea, vomiting or PACU stay
- Total PACU opioid was lower with bupivacaine (median 0 vs 2 mg morphine equivalents)
Clinical relevance
The block adds little when a good multimodal regimen is already used.
Who should care
Limitations
A single-centre trial; the small opioid reduction is of uncertain relevance.
Routine superficial cervical plexus block is not necessary within a thorough multimodal thyroidectomy regimen.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Whether adding a bilateral superficial cervical plexus block to a thyroidectomy enhanced recovery pathway improves postoperative quality of recovery remains uncertain.
Methods
In a single-center prospective, randomized, double-blind, placebo-controlled trial in adults undergoing thyroidectomy with general anesthesia, participants were randomized to bilateral superficial cervical plexus blocks with 0.25% bupivacaine or saline. All participants received multimodal analgesia with dexamethasone, acetaminophen, nonsteroidal anti-inflammatory drugs, and incisional local anesthetic. The primary outcome was quality of recovery, measured by the QoR-40 survey, on postoperative day 1. Secondary outcomes included the need for rescue opioid, total opioid consumption, nausea, vomiting, antiemetic administration, length of stay in the postanesthesia care unit (PACU), and opioid use on postoperative day 1.
Results
A total of 160 participants were randomized to receive a superficial cervical plexus block with bupivacaine 0.25% (n = 78) or saline (n = 82). On postoperative day 1, mean QoR-40 scores were 174 (95% CI, 170 to 178) for bupivacaine and 173 (95% CI, 169 to 177) for saline. The adjusted mean difference between bupivacaine versus saline was 0.91 (95% CI, -3.57 to 5.40; P = 0.688). There were no significant between-group differences in the need for opioids in the PACU or on postoperative day 1, nausea, vomiting, or PACU length of stay. However, the total amount of opioid administered in the PACU was lower in the bupivacaine group (median [interquartile range], 0 [0 to 8]) compared with the saline group (2 [0 to 20]; Hodges-Lehmann location shift, 0 morphine milligram equivalents; 95% CI, -4 to 0; P = 0.017), and fewer participants in the bupivacaine group received rescue antiemetics (3 [3.8%] vs . 13 [16%]; difference, -12%; 95% CI, -22% to -1.8%; P = 0.011).
Conclusions
Bilateral superficial cervical plexus blocks did not improve quality of recovery after thyroidectomy when added to a multimodal analgesic regimen including dexamethasone, acetaminophen, nonsteroidal anti-inflammatory drugs, and incisional local anesthetic but were associated with lower total PACU opioid consumption.
DOI
10.1097/aln.0000000000006200
PMID
42268604
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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