What question did this study set out to answer?

This study aims to assess the effect of dexmedetomidine added to ropivacaine on opioid consumption for postoperative analgesia in thyroidectomy patients.

May 10, 2026International Archives of Otorhinolaryngology1 citationsOpen Access

Enhanced Analgesia and Reduced Opioid Use with Dexmedetomidine-Ropivacaine for Superficial Cervical Plexus Block in Thyroidectomy: A Randomized Controlled Study

SBSucheta BagriNetaji Subhash Chandra Bose Medical College RGRajan B. GodwinNetaji Subhash Chandra Bose Medical College AGAshish GuptaNetaji Subhash Chandra Bose Medical College

Key Points

This study aims to assess the effect of dexmedetomidine added to ropivacaine on opioid consumption for postoperative analgesia in thyroidectomy patients.
Sixty patients were randomized into two groups for bilateral superficial cervical plexus block: one receiving ropivacaine alone and the other receiving ropivacaine with dexmedetomidine.
Postoperative analgesia was evaluated based on the morphine milligram equivalents (MMEs) consumed in the first 24 hours and total MMEs in the first 5 days.
In the first 24 hours, mean opioid requirement was significantly lower in the dexmedetomidine group (8 ± 2.85 MME) compared to the ropivacaine group (20 ± 8.14 MME; p = 0.0001).
During the first 5 days post-surgery, total MMEs were also lower for the dexmedetomidine group (18 ± 8) compared to the ropivacaine group (38 ± 16.4; p = 0.0001).
Only 2 (6.6%) patients in the dexmedetomidine group required opioids, compared to 3 (10%) in the ropivacaine group.

Abstract

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

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