The combination of non-narcotic medication and superficial cervical block with liposomal bupivacaine provides effective analgesia and reduces the need for opioids for pain relief after thyroid or parathyroid surgery, according to study results presented at the 89th Annual Meeting of the American Thyroid Association, held October 30 toNovember 3, 2019, in Chicago, Illinois.

Effective analgesia after neck surgery may reduce the risk for opioid misuse. The goal of the current retrospective study was to explore the analgesic effect of superficial cervical block with liposomal bupivacaine on the use of narcotics in 261 patients who underwent thyroidectomy and/or parathyroidectomy between June 2017 and July 2018. Of these patients, 83 (32%) did not receive any block and 178 (68%) were administered a liposomal bupivacaine block.

The need for opioids in the post-anesthesia care unit was more common among patients who received no block compared with those in the liposomal bupivacaine group (71% vs 38%, respectively; P <.01). While median pain scores were similar in both groups, intravenous narcotics were administered more frequently to patients who received no block.


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At discharge, opioid prescriptions were given to 27 patients (15%) who received liposomal bupivacaine compared with 69 patients (83%) who received no block. It was much more common for non-narcotic prescriptions to be given to patients treated with liposomal bupivacaine (146 patients [82%] vs 9 patients [10%] in the group that received no block; P <.01).

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Severe pain during the first postoperative visit was documented in 8 patients (9.6%) who received no cervical block compared with 2 patients (1%) in the liposomal bupivacaine group (P <.01).

“[Liposomal bupivavaine superficial cervical block] used in combination with non-narcotic medication provides effective analgesia postoperatively and helps to mitigate [to sic] concerns for unused and over-prescribed opioids, thus minimizing abuse and contribution to the opioid epidemic,” wrote the researchers.

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Reference

NeMoyer RE, Muraveika L, Walls D, et al. Superficial cervical block with liposomal bupivacaine decreases potoperative narcotic use for pain management after thyroidectomy and/or parathyroidectomy. Presented at: American Thyroid Association 2019 Annual Meeting; October 30-November 3, 2019; Chicago, IL. Poster 137.