Discussion
PONV, pain
To the best of our knowledge, this is the first randomized and prospective study comparing the effects of OFA combined with ultrasound-guided ICPB and opioid-based anesthesia in thyroid surgery. These results indicate that this combined strategy is feasible. It may reduce the use of vasoactive drugs during surgery, decrease the incidence of PONV, and improve the quality of postoperative recovery of patients undergoing thyroid surgery. In addition, OFA combined with ultrasound-guided ICPB can significantly reduce the VAS score of patients at rest and during swallowing. Further, it can also reduce the use of rescue analgesics after surgery.Considering that there is a positive correlation between PONV and the dose of opioids, 0.05–0.2ug/kg/min remifentanil was administered during surgery to control the occurrence of PONV in the control group as much as possible. In addition, postoperative use of dezocine to relieve pain is also an important factor leading to PONV. Despite this, we can still observe that the incidence of PONV is significantly reduced in the OFA group in subgroup analysis. Therefore, we are more inclined to maintain that OFA is a better choice than opioid-based anesthesia in reducing the incidence of PONV. A systematic review and meta-analysis by Franknecht et al. [A meta-analysis by Hung et al. [The QoR-40 score was employed to evaluate the influence of OFA on the quality of postoperative recovery. The minimal benefit of value to patients is called the “minimal clinically important difference” [