الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Thyroid surgery evolved rapidly with the help of the advanced equipment and increased experience of the surgeons. Even though the size of skin incision and operating time has been minimized currently, postoperative neck pain persists, especially in the early post-operative period. Overprescription of opioids for ambulatory procedures such as thyroid surgery is well documented, and for many procedures, routine use of opioids does not improve analgesia or postoperative outcomes compared with other strategies. Additionally, prescription of opioids still contribute substantially to the opioid crisis, and most individuals who misuse opioids were initially exposed to the drugs through the healthcare system. Subsequently, several sources provide recommendations for minimum quantities of opioid for various procedures. Quality of recovery (QoR) after anesthesia is an important measure of the early postoperative health status of patients, but postoperative outcome is considered to be positive only when it is associated with a shortened length of hospital stay and absence of postoperative functional incapacitation. Also, adequate analgesia is another factor that can be debilitating to the postoperative patient, so treatment of post-operative pain is essential and the primary target is to improve the post-operative comfort and to decrease hospital stay after surgery. However, no standard protocol has been described for the management of post-operative pain after thyroidectomy, Ultrasound (US)-guided superficial cervical plexus block (SCPB) was introduced by Tran et al and it provides effective anesthesia and analgesia for the head and neck region • The aim of this study was to evaluate US guided Bilateral SCPB as a part of enhanced recovery after thyroid surgery using QOR-15 scale as a method for assessment of quality of recovery. The primary outcome was to improve the quality of recovery assessment of it using the 15-item quality of recovery questionnaire (QoR-15). The secondary outcome was measuring postoperative analgesia defined by the visual analogue scale (VAS) score, 24 hr Opioid consumption and diaphragmatic Excursion assessed by US. The patients were randomly allocated into two equal groups by using computer generated software of randomization introduced into sealed opaque envelope technique into: group I (control group): (Sham Technique) Patients received general anesthesia plus US guided Bilateral SCPB with injection of 10 ml normal saline bilaterally. group II (Study group): Patients received general anesthesia plus US guided Bilateral SCPB with injection of total volume 10 ml containing Bupivacaine 0.25% (5 ml Bupivacaine 0.5 % and 5 ml normal saline). The main findings in the current study can be summarized by: Postoperative quality of recovery-15 (QOR-15) score was significantly higher in group II compared to group I and patients of group II remained pain free and required lower dose of morphine in the first 24 hours postoperatively than group I. Regarding patients’ demographics and surgical data, it was found that patients’ characteristics and surgical data were comparable in both groups. Also, comparison between the two studied groups according to haemodynamics (Mean arterial blood pressure and Heart rate) revealed that there was no statistically significant difference between the two groups at all study times, While intraoperative fentanyl consumption was significantly lower in group II compared to group I. There was no statistically significant difference between both groups as regard to incidence of complications.