الفهرس 
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Abstract
Thyroid surgeries are common operations that cause moderate to severe post-operative pain especially during the first post-operative day. Post-thyroidectomy pain had been managed by different ways using NSAIDS, opioids, multimodal analgesia or local wound infiltration. Regional techniques to block cervical plexus have been applied in the form of superficial CPB or intermediate CPB either blind or USG. USG combined CSSB and CCNB has been recently applied as a technique for awake thyroidectomy and for analgesia. We compared USG intermediate CPB versus cutaneous and thyroid capsular blocks to compare the difference regards analgesia, hemodynamics and side effects. Seventy four patients with ASA physical status I-II of both sexes aged from 20-60 years scheduled for elective thyroid surgeries were randomly assigned to one of two equal groups (n=37 each), using closed envelope technique: Capsule-sheath space block combined with anterior cervical cutaneous nerves block group (group CC). Ultrasound-guided intermediate cervical plexus block group (group IC). Patients of both groups received the block after general anesthesia and surgical procedure was started 15 minutes after performing the block. Data regarding the time to first analgesic request, intra-operative and post-operative hemodynamics were recorded. Pain score, sensory block distribution, incidence of side effects and total postoperative pethidine consumption were assessed. Our results showed USG intermediate cervical plexus block to be slightly superior to cutaneous and thyroid capsular blocks regards longer time to the 1st request of analgesia, lower dose of rescue analgesia, wider sensory block, higher surgeon satisfaction, lower VAS after 16 h with similar side effects so it is preferred in presence of ultrasound and experienced practitioner. Otherwise, cutaneous and thyroid capsular blocks can be an alternative to USG intermediate cervical plexus block in absence of ultrasound and or experienced personnel.