A Phase 4 interventional study of Bupivacain only and Bupivacain only in Post Operative Pain Relief After Thyroidectomy, sponsored by Assiut University. Recruiting at 1 site in Egypt. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-09-01.
Sponsored by Assiut University · Phase 4, Interventional, and Treatment
Thyroidectomy is commonly associated with mild-to-moderate postoperative pain that may affect respiratory function and recovery. Bilateral intermediate cervical plexus block provides effective analgesia, but larger local anesthetic volumes may increase phrenic nerve spread and diaphragmatic dysfunction. Low-volume ultrasound-guided block may provide adequate analgesia while better preserving diaphragmatic function and postoperative respiratory performance
Thyroidectomy requires effective perioperative analgesia to facilitate swallowing, coughing, deep breathing, and early mobilization. Bilateral intermediate cervical plexus block improves postoperative pain control and reduces opioid requirements, while ultrasound guidance enhances safety and accuracy. However, larger local anesthetic volumes may increase phrenic nerve involvement and diaphragmatic impairment. Ultrasound assessment of diaphragmatic excursion and thickening fraction provides objective evaluation of respiratory function. Low-volume block may preserve diaphragmatic function while maintaining satisfactory analgesic efficacy
Exclusion Criteria:
Ultrasound-guided bilateral intermediate cervical plexus block using 5 mL of bupivacaine0.5% .on each side.
Drug: Bupivacain only
Ultrasound-guided bilateral intermediate cervical plexus block using 10 mL of bupivacaine 0.25% . on each side.
Drug: Bupivacain only
Bilateral intermediate cervical plexus block using ultrasound-guided bupivacaine 0.5% for low volume group
Bilateral intermediate cervical plexus block using ultrasound-guided bupivacaine 0.25% for standard group
Change in diaphragmatic excursion in patient undergoing thyroidectomy
Ultrasound-measured diaphragmatic excursion (cm), assessed at baseline before block and at predefined postoperative time points, to compare the effect of low-volume versus standard-volume bilateral intermediate cervical plexus block on diaphragmatic function.
Time frame: Baseline before block, 30 minutes after block.4 hour after block
Postoperative Pain Score visual analog scale (vas)
Postoperative pain assessed using the Visual Analog Scale (VAS, 0-10) at rest and during swallowing.
Time frame: Postoperative pain score PACU arrival (0 hour), 6 hour, 12 hour, and 24 hour postoperatively
Total opioid consumption in 24hr postoperative
Total amount of opioid consumption in patient undergoing thyroidectomy for first 24hr postoperative
Time frame: After 24hour PACu arrival
Plan to share: No
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Assiut University