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Abstract Introduction

There are concerns about addiction to opioids due to excessive prescription after surgery.

Objective

We compared the impact of dexmedetomidine as an additive to ropivacaine for bilateral cervical plexus block to that of ropivacaine alone for postoperative analgesia in patients undergoing thyroidectomy.

Methods

A total of 60 patients were randomized in 2 groups: those submitted to bilateral superficial cervical plexus block (BSCPB) using 0.375% ropivacaine (group BSCPB-R, the control group) and those submitted to BSCPB using 0.375% ropivacaine with 1mcg/kg of dexmedetomidine (group BSCPB-RD, the study group). The resultant postoperative analgesia was compared by the morphine milligram equivalents (MMEs) required by each patient.

Results

Only 3 (10%) patients in the BSCPB-R group and 2 (6.6%) patients in the BSCPB-RD group required opioid analgesia. The mean total rescue opioid required in the first 24 hours was significantly higher in group BSCPB-R compared to group BSCPB-RD (20 ± 8.14 versus 8 ± 2.85 MME respectively; p = 0.0001). Similarly, the mean total MMEs required during the first 5 days after surgery was of 38 ± 16.4 for group BSCPB-R and 18 ± 8 for group BSCPB-RD (p = 0.0001).

Conclusion

The combination of dexmedetomidine and ropivacaine in the BSCPB protocol results in a lower requirement of opioids for pain in the postoperative period, and very few (if any) patients undergoing thyroid surgery require postoperative opioids with this strategy.

Keywords thyroidectomy - opioid analgesia requirement - bilateral superficial cervical plexus block - dexmedetomidine Data Availability

Data will be available upon request to the corresponding author.

Editor-in-Chief: Geraldo Pereira Jotz.

Publication History

Received: 23 September 2024

Accepted: 24 May 2025

Article published online:
08 May 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Sucheta Bagri, Rajan B. Godwin, Ashish Gupta, Shivank Sethi, Neeraj Narang, Sanjay Kumar Yadav, Dhananjaya Sharma. Enhanced Analgesia and Reduced Opioid Use with Dexmedetomidine-Ropivacaine for Superficial Cervical Plexus Block in Thyroidectomy: A Randomized Controlled Study. Int Arch Otorhinolaryngol 2026; 30: s00461819561.
DOI: 10.1055/s-0046-1819561