Effect of Bilateral Superficial Cervical Plexus Block on Postoperative Pain in Thyroid and Parathyroid Surgery: A Systemic Review and Meta-Analysis.

BACKGROUND Postoperative pain management following thyroid and parathyroid surgery is crucial for patient recovery and satisfaction. Bilateral superficial cervical plexus block (BSCPB) has gained attention as an effective regional anesthesia technique for managing postoperative pain. However, the overall effectiveness of BSCPB, particularly with adjuncts like dexmedetomidine or ropivacaine, remains unclear. This meta-analysis evaluated the efficacy of BSCPB in reducing postoperative pain in patients undergoing thyroid and parathyroid surgery, and assessed the impact of adjuncts on pain management. MATERIAL AND METHODS A systematic search of PubMed, Scopus, Cochrane Library, and Embase was conducted for randomized controlled trials and observational studies that investigated BSCPB in thyroid and parathyroid surgery. Studies were assessed for quality using the Jadad scale. Pooled risk ratios and 95% confidence intervals were calculated using a random-effects model. Subgroup analyses were performed to assess the impact of adjuncts. RESULTS We included 20 studies, representing a diverse range of geographical settings. There were 1507 patients in this study, and 753 of them were in the BSCPB group. The pooled analysis showed that BSCPB significantly reduced postoperative pain (p<0.05). The most significant reduction in pain was observed in the 6-24 hours after surgery. Subgroup analysis revealed that the addition of adjuncts provided modest further pain relief. CONCLUSIONS BSCPB is a highly effective method for reducing postoperative pain following thyroid and parathyroid surgeries. The addition of adjuncts offers some additional pain relief. These findings support the use of BSCPB as an opioid-sparing pain management strategy in these surgeries.