AB171. SOH26AB_0165. Network meta-analysis of methods of local anaesthetic delivery for thyroid surgery
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AB171. SOH26AB_0165. Network meta-analysis of methods of local anaesthetic delivery for thyroid surgery

James Lennon, Darragh McGovern, Oisin O’Donnell, Aya Mahdi, Jack Collins, Eoin Kerin, Stewart Redmond Walsh, Aoife Lowery

Department of Surgery, University Hospital Galway, Galway, Ireland

Background: Both local wound infiltration (LWI), superficial bilateral cervical blocks (SBLCB), and intermediate bilateral cervical blocks (IBLCB) have been reported to lower pain scores and post-operative adverse effects after thyroidectomy. It is not clear, however, which of these modalities provides the best local anaesthetic (LA) effect when compared to no LA delivery in patients undergoing thyroidectomy. We aimed to perform a network meta-analysis (NMA) of randomized controlled trials (RCTs) comparing LWI, SBLCB, and IBLCB to either no LA use (control) or to each other to determine the effects of LA administration and identify the optimal method of administration

Methods: An NMA was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA)-NMA guidelines. A search of the PubMed, Scopus, Embase, and Cochrane databases was conducted. Analysis was performed using R packages and Shiny.

Results: A total of 29 RCTs comparing LWI, SBLCB, and IBLCB to either each other or control, including 2,251 patients. SBLCB prolonged time to rescue analgesia when compared to control for longer [5.85; 95% confidence interval (CI): 4.36 to 7.35] than LWI did when compared to control (0.98; 95% CI: 0.25 to 1.7). IBLCB compared to control showed a significantly decreased rate of post-operative nausea and vomiting (−1.28; 95% CI: −2.55 to −0.017) and a reduced number of patients requiring post-operative analgesia (−1.66; 95% CI: −3.14 to −0.018). However, no LA administration method showed a significant advantage in pain scores at 24 h when compared to control.

Conclusions: These results suggest that while LWI remains an efficient and worthwhile option for the reduction of pain in the immediate post-operative period, SBLCB and IBLCB may offer advantages over it when resources and time allow.

Keywords: Cervical nerve block; local anaesthesia; local wound infiltration (LWI); network meta-analysis (NMA); thyroidectomy

Acknowledgments

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-26-ab171
Cite this abstract as: Lennon J, McGovern D, O’Donnell O, Mahdi A, Collins J, Kerin E, Walsh SR, Lowery A. AB171. SOH26AB_0165. Network meta-analysis of methods of local anaesthetic delivery for thyroid surgery. Mesentery Peritoneum 2026;10:AB171.

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