Impact of Ultrasound-guided Superficial Cervical Plexus Block on Early Postoperative Recovery in Patients Undergoing Microvascular Decompression: A Randomized Controlled Trial

BACKGROUND: Cervical plexus block (CPB) provides postoperative analgesia and reduces postoperative nausea and vomiting (PONV), which are important for improving the quality of recovery after head and neck surgical procedures. This randomized controlled trial investigated the effect of superficial CPB on early postoperative quality of recovery in patients undergoing microvascular decompression (MVD). METHODS: Patients undergoing MVD for trigeminal neuralgia and hemifacial spasm were randomly assigned to receive superficial CPB or not (n = 30 per group). Ultrasound-guided superficial CPB was performed with 10 cc of 0.5% ropivacaine before surgery. The primary outcome measure was the Korean version of the 15-item Quality of Recovery (QoR-15K) score on postoperative day 1. The secondary outcome measures included postoperative pain scores, the incidence of PONV, and perioperative inflammatory cytokine levels. RESULTS: The QoR-15K score on postoperative day 1 did not show a significant difference (94.5 [68.0-116.0] vs. 80.5 [51.5-100.8], P = 0.077) between the 2 groups. Perioperative QoR-15K scores also showed no significant time × group effect ( P = 0.324). Postoperative pain scores did not differ between the 2 groups. The incidence of PONV was significantly reduced in the superficial CPB group at 6 ( P = 0.001) and 12 ( P < 0.001) hours postoperatively. Perioperative inflammatory cytokine levels showed no differences between the 2 groups. CONCLUSIONS: Superficial CPB did not improve early postoperative QoR in patients undergoing MVD. However, it reduced the incidence of PONV during the early postoperative period, which could potentially enhance patient comfort and satisfaction.