A study by Jing Gong and researchers found the use of combination of Ultrasound-guided bilateral cervical plexus block plus general anesthesia to be effective for improving the anesthesia management and postoperative analgesia following total parathyroidectomy with autotransplantation surgical procedure.

This deduction was based on 48 patients with hyperparathyroidism secondary to renal failure as per the American Society of Anesthesiologists (ASA) III–IV criteria. These patients were segreggated in two groups of 24 patients each to receive ultrasound-guided bilateral superficial and deep cervical plexus block plus general anesthesia (group A), and just general anesthesia (group B). Sufentanil 2 μg/kg intravenous (IV ) was used as postoperative patient-controlled analgesia. Postoperative pain scores was considered as primary outcome. Changes in hemodynamics, intraoperative remifentanil dosage, extubation time, and sufentanil use was considered as secondary outcome.

Group A patients required less remifentanil (2.56± 0.92mg) compared to group B (3.38± 0.84mg). Lower VAS scores was observed in group A, as shown in the following figure:

Figure 1: Postoperative pain trends during 48 hours

Although the systolic blood pressure in group A patients was considerably greater than group B immediately after extubation (T3), group A had lower heart rates than in group B a minute prior to induction and after intubation. Both groups had no difference in values of parathormone, calcium and phosphorus or even sufentanil usage.