The Efficacy of Bupivacaine with Adrenaline in Reducing Pain and Bleeding associated with Subtotal Thyroidectomy

Thyroid surgery commonly associated with perioperatively and postoperative bleeding and some initial pain on swallowing after surgery, and these are a common problems encountered till now. The use of certain medications might help to minimize blood loss during and after surgery with reduction of pain and operative time. The aim is to have a better surgical field with a good analgesia.A randomized study in Al Karkh hospital was performed including 22 cases submitted to bilateral subtotal thyroidectomy surgery divided into 2 groups; group A; 10 patients had the usual type of surgery with using the combination of bupivacaine 0.25% and adrenaline 1:200000 after induction of anesthesia to be injected in the operative site. The second group B involves the other 12 patients who were operated on without local infiltration. This study was designed to compare differences in both groups regarding to total blood loss, analgesic effect and duration of surgery Our study included 20 females and 2 male with enlarging goiter involving both lobes, with less blood loss in suction apparatus and drains as well as there was a less scores regarding pain relief during and after surgery in group A than group B. No significant statistical differences in term of morbidity and mortality for both groups regarding the local bleeding control during thyroid, peri-incisional infiltration provided better pain relief in early postoperative period. Key words: Thyroid surgery, Bupivacaine, Adrenaline, Pain scores, Bleeding and Suction drains, suction apparatus