Evaluation of perioperative cortisol levels, hemodynamics, and VAS scores of the patients undergoing thyroid and parathyroid surgery using combined regional neck anesthesia

Several studies prove the obvious advantage of regional blockade over general anesthesia in thyroidectomy. However, there is only one work demonstrating the effectiveness of a combination of transverse cervical nerve block and bilateral cervical plexus block in thyroid surgery. The aim of the work was to evaluate the effectiveness of the use of regional anesthesia under ultrasound navigation in patients during operations on the thyroid and parathyroid glands, including bilateral superficial cervical plexus block, pericapsular block of the thyroid gland, blockade of the Berry ligament. The study endpoints included the following: fentanyl consumption; cortisol levels and hemodynamic parameters before, during, 3 hours and 12 hours after the operation; VAS score 3 hours and 12 hours after the operation. The study included 60 adult patients who underwent surgery on the thyroid gland. Group 1 patients underwent general anesthesia using ventilation, bilateral intermediate cervical plexus block in combination with pericapsular block of the thyroid gland, and blockade of the Berry ligament under ultrasound navigation. The 2nd group of patients underwent combined general anesthesia using ventilation. Group 1 patients demonstrated lower consumption of fentanyl during the intraoperative and of NSAIDs during the postoperative periods, faster activation, adequate hemodynamic status, decreased cortisol levels, and minimal pain. Group 2 patients had pronounced pain at 3 hours after surgery, pain persistence after 12 hours, and arterial hypertension. Patients in the general anesthesia group required additional administration of NSAIDs in the postoperative period. Keywords: thyroidectomy, regional cervical plexus block, postoperative pain, cortisol, blood pressure Conflicts of interest. The authors have no conflicts of interest to declare. Funding. There was no funding for this study