Multimodal analgesia with ropivacaine wound infiltration and intravenous flurbiprofen axetil provides enhanced analgesic effects after radical thyroidectomy: a randomized controlled trial.

backgroundThyroidectomy is a common procedure that causes mild trauma. Nevertheless, postoperative pain remains a major challenge in patient care. Multimodal analgesia comprising a combination of analgesics and analgesic techniques has become increasingly popular for the control of postoperative pain. The present study tested the hypothesis that multimodal analgesia with combined ropivacaine wound infiltration and intravenous flurbiprofen axetil after radical thyroidectomy provided better analgesia than a single dosage of tramadol.

methodsThis randomized controlled trial was conducted in a tertiary hospital. Forty-four patients (age, 18-75 years; American Society of Anesthesiologists status I or II; BMI < 32 kg/m

resultsNRS scores at rest were significantly lower in Group M than in Group C before discharge from the postoperative anesthetic care unit (P = 0.003) and at 2 (P = 0.008), 4 (P = 0.020), and 8 h (P = 0.016) postoperatively. Group M also had significantly lower NRS scores during coughing/swallowing at 5 min after extubation (P = 0.017), before discharge from the postoperative anesthetic care unit (P = 0.001), and at 2 (P = 0.002) and 4 h (P = 0.013) postoperatively. Compared with Group C, NRS scores were significantly lower throughout the first 24 h postoperatively in Group M at rest (P = 0.008) and during coughing/swallowing (P = 0.003). No serious adverse events were observed in either group.

conclusionMultimodal analgesia with ropivacaine wound infiltration and intravenous flurbiprofen axetil provided better analgesia than tramadol after radical thyroidectomy.

trial registrationChinese Clinical Trial Registry (registration number # ChiCTR1800020290 ; date of registration: 22/12/2018).