الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
SCP is formed by the cutaneous nerves of the cervical plexus that is derived from the anterior primary rami of C2 – C4. It innervates the antero-lateral side of the neck, ante-auricular and retro-auricular skin areas and skin immediately inferior to the clavicle on the chest wall. SCP block in combination with GA in thyroid gland surgery may help in reduction of post-operative pain, total opioid analgesics requirement, PONV and shorter hospital stay. US guidance during SCP block practices improves success and safety of the block. A number of drugs (as opioids, benzodiazepines, α2 agonists, N-methyl D-aspartate receptor antagonist, dexamethasone and neostigmine) have been used in pripheral nerve block as an adjuvant to LA. Mg has anti-nociceptive effects due to its antagonistic effect on NMDA receptors which play a major role in central nociceptive transmission, modulation and sensitization of acute and chronic pain states. Also, recent studies identified NMDA receptors peripherally in the skin, muscles and knee joints and found that they play a role in sensory transmission of noxious signals. Additionally, Mg reduces calcium influx and may augment opioid analgesia. This study, aimed at proving that adding MgSo4 to bupivacaine in US guided SCP block may be more superior to bupivacaine alone as regard analgesic effect and duration of analgesia without more complications. So, 82 patients who underwent elective thyroid surgery (multinodular goiter and solitary thyroid nodule), were allocated into two groups (41 patients in each group): SCP with bupivacaine group (group-B) and SCP block with Mgso4 and bupivacaine group (group-M). VAS application was explained to all patients in the preoperative visit. In both group (B, M), the block was performed using an US (SIEMENS ACUSON P300) by injecting 5 mL of 0.5% isobaric bupivacaine + 5 mL saline in each side or 5 mL of 0.5% isobaric bupivacaine + 5 mL of 10% MgSo4 (500 mg) in each side according to each group. The following data was recorded before and after induction, at skin incision and every 15 min throughout the first hour of surgery and every 30 min throughout the surgery (heart rate, mean arterial blood pressure, SpO2, Etco2). Immediately after surgery, the patient was moved to PACU and the following data was recorded at 1h, 2h, 6h, 12h and 24h Heart rate, mean arterial blood pressure and VAS. Ramsay scale for scoring sedation was recorded at 1h postoperatively. First request for analgesia, total postoperative analgesic consumption, presence of complication was also recorded Our results proved that adding of MgSo4 to bupivacaine for US guided SCP block made the analgesic duration longer and decreased the postoperative pain after elective thyroid surgery.