The Interscalene technique preferentially blocks the caudal nerves of the cervical plexus
and cephalad nerves of the brachial plexus.
Considering that these branches extend from the cervical plexus
to the SAN and the motor branches extend to the middle and inferior parts of the trapezius muscle, it appears likely that damage to the cervical plexus
causes shoulder pain.
Patients and Methods: A total of 45 cases of ASA II and ASA III physical status were operated for carotid endarterectomy under local block of cervical plexus
General anaesthesia is most commonly used, but cervical plexus
block and local anaesthesia with hypnosis have been used successfully in adults.
Superficial or deep cervical plexus
block for carotid endarterectomy: a systematic review of complications.
Batson and Eckenhoff showed that there were multiple anastomoses and free connections between this venous plexus and the dural sinuses, the emissary veins of the skull as well as numerous junctions with the cervical plexus
The cervical plexus
consists of the ventral primary divisions of the first four cervical spinal nerves and gives rise to (1) the muscular branches, including the phrenic nerve and nervus descendens cervicalis, as well as (2) the sensory branches, including the lesser occipital, transverse cutaneous, supraclavicular, and great auricular nerves.
Four studies compared superficial cervical plexus
block to placebo in patients having thyroid surgery (65-68).
No e/o significant cervical plexus
block is indicated to aid in head and neck surgery, potentially providing excellent anaesthesia and/or analgesia in the cervical region (1,2).
These modifications include techniques to preserve various functionally important anatomic structures, particularly the spinal accessory nerve, the jugular vein, the sternocleidomastoid muscle, and the cervical plexus
of the sensory nerves.
Those patients posted for clavicular surgeries were supplemented with superficial cervical plexus
block using 2% lidocaine with adrenaline 10cc along with classical interscalene brachial plexus block.
It has been proposed that injection of local anesthetic drug into cervical plexus
(1,2,3) bilaterally could easily lead to establishment of block appropriate for thyroid surgery without any significant side effects.
In our literature search, there was only one previous report on the use of a deep cervical plexus
block for surgical decompression in a patient with Ludwig's angina and severe airway compromise (3).
Under aseptic precautions after local infiltration of skin with local anesthetic solution, left deep Cervical Plexus
block achieved by injecting 15 ml of combined 1% Lignocaine and 0.