| Author/Editor | Stopar-Pintarič, Tatjana; Hočevar, Marko; Jereb, Simona; Casati, A; Novak-Jankovič, Vesna | |
| Title | A prospective, randomized comparison between combined (deep and superficial) and superficial cervical plexus block with levobupivacaine for minimally invasive parathyroidectomy | |
| Type | članek | |
| Source | Anesth Analg | |
| Vol. and No. | Letnik 105, št. 4 | |
| Publication year | 2007 | |
| Volume | str. 1160-3 | |
| Language | eng | |
| Abstract | Background: Minimally invasive parathyroidectomy (MIP) can be performed under cervical plexus block (CPB). Superficial CPB has been reported to be easier to perform with similar efficacy and less anesthesia-related complications than combined deep and superficial CPB. In this study, we compared the efficacy of superficial and combined (deep and superficial) CPB in patients undergoing MIP. Methods: Forty-two patients with primary hyperparathyroidism due to a solitary adenoma were randomized to receive either a superficial (group superficial, n = 20) or a combined deep and superficial CPB (group combined, n = 22) using 0.35 mL/kg of 0.5% levobupivacaine. The primary end-point was the amount of supplemental fentanyl required to complete surgery. Results: There were no differences in onset of block, pain scores during surgery, or time to first analgesic request between groups. Fentanyl consumption was similar in both groups, i.e., 50 (0-200) microg in group superficial and 50 (0-100) microg in group combined (P = 0.60). Six patients [1 in group superficial (5%) and 5 in group combined (22.7%)] were converted to general anesthesia for surgically required bilateral neck dissection (P = 0.18). General anesthesia for block failure was reported in three superficial (15%) and two combined group patients (9%) (P = 0.99). In group combined, only one patient (4.5%) showed diaphragmatic paresis after the block (P = 0.99). Conclusion: Superficial CPB is an alternative to combined block for MIP. | |
| Descriptors | ANESTHETICS, LOCAL CERVICAL PLEXUS PARATHYROIDECTOMY ADENOMA AGED BUPIVACAINE DOUBLE-BLIND METHOD INTRAOPERATIVE PERIOD NERVE BLOCK PAIN MEASUREMENT PARATHYROID NEOPLASMS PATIENT SATISFACTION |