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The Effect of Bilateral Intermediate Cervical Plexus Block on the Surgical Stress Response Following Total Thyroidectomy

4. August 2026 aktualisiert von: Antonija Mihelcic, University Hospital Dubrava

The Effect of Ultrasound-guided Bilateral Intermediate Cervical Plexus Block on Serum Biomarkers of the Surgical Stress Response Following Total Thyroidectomy

Total thyroidectomy triggers a systemic surgical stress response involving neuroendocrine and inflammatory pathways. Ultrasound-guided bilateral intermediate cervical plexus block (BICPB) is commonly utilized for postoperative analgesia, however, its specific impact on modulating the systemic stress biomarker response remains to be fully elucidated.

To evaluate the effect of an ultrasound-guided BICPB on the perioperative surgical stress response by comparing changes in specific serum inflammatory and metabolic biomarkers between patients receiving BICPB and those receiving total intravenous anesthesia (TIVA) alone.

In this prospective, randomized, controlled study, a total of 48 eligible patients scheduled for elective total thyroidectomy will be randomly assigned to two groups of 24 participants each:

  • BICPB Group: TIVA combined with an ultrasound-guided bilateral intermediate cervical plexus block.
  • Control Group: TIVA alone.

Venous blood samples will be collected at predefined intervals: preoperatively (baseline), immediately postoperatively, 24 hours and 48 hours post-surgery.

It is hypothesized that integrating an ultrasound-guided bilateral intermediate cervical plexus block with total intravenous anesthesia (TIVA) will significantly attenuate the surgical stress response, as evidenced by a reduction in specific serum biomarker concentrations (interleukin-6, C-reactive protein, total leukocyte count,cortisol, alpha-amylase, and glucose), compared to utilizing TIVA alone during total thyroidectomy.

Testing this hypothesis aims to provide scientific evidence regarding the routine integration of the bilateral intermediate cervical plexus block into standard anesthetic protocols for total thyroidectomy, with the objective of evaluating its potential to minimize perioperative stress and support postoperative patient recovery.

Studienübersicht

Status

Noch keine Rekrutierung

Bedingungen

Intervention / Behandlung

Studientyp

Interventionell

Einschreibung (Geschätzt)

48

Phase

  • Phase 4

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienkontakt

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

  • Erwachsene
  • Älterer Erwachsener

Akzeptiert gesunde Freiwillige

Nein

Beschreibung

Inclusion Criteria:

  • ASA I or ASA II
  • euthyroid status
  • signed informed consent

Exclusion Criteria:

  • patients who refuse to sign the informed consent form
  • infection at the block injection site
  • hypersensitivity or contraindications to the medication used in the study
  • hypo/hyperthyroidism at the time of surgery
  • presence of substernal goiter
  • additional surgical interventions during the procedure
  • history of previous neck surgery or radiation
  • coagulopathy
  • uncontroled respiratory disease
  • diabetes mellitus
  • autoimune disease
  • chronic corticosteroid therapy
  • smokers
  • pregnant women

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: Zufällig
  • Interventionsmodell: Parallele Zuordnung
  • Maskierung: Single

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Kein Eingriff: TIVA alone
Experimental: TIVA +ultrasound-guided bilateral intermediate cervical plexus block
Following general anesthesia induction, patients in the study group will receive an ultrasound-guided bilateral intermediate cervical plexus block. The cervical plexus will be identified on the ultrasound screen as a small cluster of hypoechoic nodules located beneath the posterolateral border of the sternocleidomastoid muscle and superior to the prevertebral fascia. Under sterile conditions, a 22-gauge needle will be advanced lateromedially using dynamic ultrasound visualization. Once the needle tip is properly positioned within this interfascial space, roughly 2 cm medial to the insertion point, negative aspiration will be confirmed. Subsequently, 10 mL of 0.25% levobupivacaine will be injected under direct ultrasound observation. The identical procedure will then be performed on the contralateral side.

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Serum Interleukin-6 Concentration
Zeitfenster: Baseline (preoperatively), 1 hour after the completion of surgery, 24 and 48 hours after the completion of surgery
Unit of measure: pg/mL
Baseline (preoperatively), 1 hour after the completion of surgery, 24 and 48 hours after the completion of surgery
Serum C-reactive protein Concentration
Zeitfenster: Baseline (preoperatively), 1 hour after the completion of surgery, 24 and 48 hours after the completion of surgery
Unit of measure: mg/L
Baseline (preoperatively), 1 hour after the completion of surgery, 24 and 48 hours after the completion of surgery
Total Leukocyte Count
Zeitfenster: Baseline (preoperatively), 1 hour after the completion of surgery, 24 and 48 hours after the completion of surgery
Unit of measure: count x 10^9/L
Baseline (preoperatively), 1 hour after the completion of surgery, 24 and 48 hours after the completion of surgery
Serum Cortisol Concentration
Zeitfenster: Baseline (preoperatively), 1 hour after the completion of surgery, 24 and 48 hours after the completion of surgery
Unit of measure: nmol/L
Baseline (preoperatively), 1 hour after the completion of surgery, 24 and 48 hours after the completion of surgery
Serum Alpha-amylase Activity
Zeitfenster: Baseline (preoperatively), 1 hour after the completion of surgery, 24 and 48 hours after the completion of surgery
Unit of measure: U/L
Baseline (preoperatively), 1 hour after the completion of surgery, 24 and 48 hours after the completion of surgery
Serum Glucose Concentration
Zeitfenster: Baseline (preoperatively), 1 hour after the completion of surgery, 24 and 48 hours after the completion of surgery
Unit of measure: mmol/L
Baseline (preoperatively), 1 hour after the completion of surgery, 24 and 48 hours after the completion of surgery

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Total Intraoperative Sufentanyl Consumption
Zeitfenster: Intraoperative period
Unit of measure: mcg/kg/min
Intraoperative period
Time to Rescue Analgesia
Zeitfenster: During the first 24 hours after the completion of surgery
Unit of measure: minutes
During the first 24 hours after the completion of surgery
Hemodynamic Stability (blood pressure)
Zeitfenster: Intraoperative period and during the first 24 hours after the completion of surgery

Systolic, diastolic and mean arterial pressure will be recorded during the research peroid.

Unit of measure: mmHg

Intraoperative period and during the first 24 hours after the completion of surgery
Total Postoperative Analgetics Consumption
Zeitfenster: During the first 24 hours after the completion of surgery
Unit of measure: mg
During the first 24 hours after the completion of surgery
Hemodynamic Stability (heart rate)
Zeitfenster: Intraoperative period and during the first 24 hours after the completion of surgery
Unit of measure: beats/minute
Intraoperative period and during the first 24 hours after the completion of surgery
Postoperative Sedation Level
Zeitfenster: During the first 4 hours after the completion of surgery
Postoperative sedation level will be mesured by Richmond Agitation-Sedation Scale ranging from -5 (deepely sedated) to +4 (highly agitated), with 0 being completely alert and calm.
During the first 4 hours after the completion of surgery

Andere Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Postoperative Nausea and Vomiting
Zeitfenster: During the first 24 hours after the completion of surgery
The incidence of postoperative nausea and vomiting will be determined
During the first 24 hours after the completion of surgery
The Incidence of Block Complication
Zeitfenster: From the administration of the block up to 48 hours after the completion of surgery
The incidence of possible complication of the block will be determined.
From the administration of the block up to 48 hours after the completion of surgery

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Geschätzt)

15. August 2026

Primärer Abschluss (Geschätzt)

15. März 2027

Studienabschluss (Geschätzt)

15. April 2027

Studienanmeldedaten

Zuerst eingereicht

28. Juli 2026

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

28. Juli 2026

Zuerst gepostet (Tatsächlich)

31. Juli 2026

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

7. August 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

4. August 2026

Zuletzt verifiziert

1. Juli 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Andere Studien-ID-Nummern

  • 0119-04-02

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UNENTSCHIEDEN

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

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