In the domain of endocrine gland surgery, thyroidectomy is the most common procedure.
Patients report moderate to severe discomfort postoperatively, which is induced by a variety
of mechanisms, the most common of which are cervical incision and surgical maneuvers. The
other two causes are endotracheal intubation and neck overextension. Incisional pain,
odynophagia, dysphagia, neck and shoulder pain have all been reported as sources of
discomfort.However, it seems that this discomfort has a time limit, with a considerable
decrease in pain scores that will last 24 to 36 hours. Pain is felt more profoundly within
the first few hours after surgery, peaking at 6 hours, with patients requesting further
analgesic medication.
Surgical wound infiltration can inhibit this procedure by preventing the alginate signal from
reaching the incision site's receptors. According to the multimodal analgesia trends,
magnesium sulfate can be added to the ropivacaine solution. Magnesium acts as an NMDA
(N-methyl-D-aspartate) receptor antagonist, inhibiting cerebral sensitization to peripheral
pain stimuli while reducing pre-existing hyperalgesia.
It becomes evident that this combination could contribute to attain the maximum analgesic
efficacy. So, if any superiority of ropivacaine plus magnesium sulphate over ropivacaine
could be demonstrated this would be very helpful in providing sufficient analgesic effects
with a low incidence of adverse effects, while enhancing the option of one day surgery.