Thyroidectomy is the most common endocrine and head-and-neck surgical procedure worldwide [1]. Classic complications such as postoperative hematoma, hypocalcemia, and laryngeal nerve palsy have been minimized in recent years as a result of the development of advanced equipment and increased experience with contemporary surgical techniques. Even in recent years, this surgery will be undertaken as an outpatient procedure [2].

Postoperative pain is one of surgical patients' primary concerns [3]. Despite the fact that thyroidectomy typically results in mild trauma, the surgery may cause moderate to severe postoperative pain, especially in the initial postoperative hours. The leading causes of pain are wound incision, hyperextension of the neck, wound edge retraction, and surgical dissection. Effective postoperative pain management can provide patients with comfort, abbreviate functional recovery time, and expedite their return to work and daily activities. Consequently, optimizing postoperative pain management is a crucial perioperative objective, particularly in ambulatory settings.

This objective has been accomplished using opioids and nonsteroidal anti-inflammatory medications (NSAIDs) in conventional pain management. However, NSAIDs have been related to potential adverse effects such as surgical bleeding and renal impairment [4] while opioids have been linked to respiratory depression, sedation, urinary retention, and nausea and vomiting [5]. For these reasons, the utilization of other alternatives has become an urgent challenge and a topic of current research.

Local anesthetics have long been used in postoperative pain management to reduce the need for intravenous medications after a variety of surgical procedures. Surgical wound infiltration (WI) has been shown to reduce the need for analgesics in a variety of surgical procedures, including herniorrhaphy and breast surgery, among others [6,7]. The administration technique is simple and can be readily performed by surgeons, but the analgesic effect is only temporary.

To date, several trials have been published evaluating the usefulness of WI with local anesthetics for the treatment of pos thyroidectomy pain. Despite some conflicting results, most of them have concluded that this strategy is effective in treating postoperative pain. However, only one systematic review has been performed that evaluated a few studies, included distant-access surgery, and focused on the use of ropivacaine [8]. There are still some questions related to the duration of effect of WI and the type of drug to use. Therefore, we decided to perform a systematic review and meta-analysis to try to resolve these concerns.