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Analgesia for Awake Internal Jugular Vein Cannulation in Trauma Emergency Bay: A Randomized Comparison of Ultrasound-Guided Superficial Cervical Plexus Block With Local Infiltration.

Kajal Jain·Nidhi Bhatia·Ankita Goyal·Amiya K Barik·Jeetinder Kaur Makkar·Bismanjeet Kaur Khurana·Mandeep Tundak·Revathi S Nair
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Abstract

BACKGROUND: Internal jugular vein (IJV) cannulation is a critical component of trauma resuscitation but is often associated with significant pain during vessel dilation and suturing when performed under local anesthetic (LA) infiltration. OBJECTIVES: We hypothesized that an ultrasound (USG)-guided superficial cervical plexus block (SCPB) would provide superior analgesia and improve procedural efficiency in awake trauma patients compared to standard LA infiltration. METHODS: This was a prospective, randomized study of conscious, adult trauma patients requiring IJV cannulation. Participants were randomized to receive either 10 mL of 1% lignocaine via ultrasound-guided SCPB (Group S) or LA infiltration (Group L). The primary outcome was procedural pain measured by Numeric Rating Scale (NRS 0-10) during skin puncture, vessel dilation, catheter insertion, and suturing. Secondary outcomes included total procedure time, Verbal Numeric Rating Discomfort Scale (0-10), and complications. RESULTS: We enrolled 60 patients, with 30 patients assigned to each study group. Median NRS pain scores were significantly lower in Group S compared to Group L at all procedural time points (p < 0.01). The total procedure time was reduced by approximately 50% in Group S (7.5 min [interquartile range (IQR) 6.0-9.3]) compared to Group L (15.5 min [IQR 9.5-16.5]; p < 0.01). Patient discomfort scores were also significantly lower in Group S (p < 0.01). No periprocedural complications were reported in either group. CONCLUSION: Ultrasound-guided SCPB may be a useful alternative to local infiltration for IJV cannulation in selected awake trauma patients, when performed by clinicians experienced in ultrasound-guided regional anesthesia. By providing comprehensive sensory coverage, the technique significantly reduces procedural time and enhances patient cooperation without need for systemic sedation.

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HumansFemaleMaleProspective StudiesMiddle AgedAdultJugular VeinsCervical Plexus BlockUltrasonography, InterventionalAnalgesiaPain MeasurementAnesthetics, LocalAnesthesia, LocalPain ManagementCatheterization, Central VenousAgedanalgesiacentral venous cannulationsuperficial cervical plexus blocktraumaultrasound-guidedJournal ArticleRandomized Controlled Trial

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Kajal Jain, Nidhi Bhatia, Ankita Goyal, Amiya K Barik, Jeetinder Kaur Makkar, Bismanjeet Kaur Khurana, Mandeep Tundak, Revathi S Nair. 2026-07-12. Analgesia for Awake Internal Jugular Vein Cannulation in Trauma Emergency Bay: A Randomized Comparison of Ultrasound-Guided Superficial Cervical Plexus Block With Local Infiltration.. https://doi.org/10.1016/j.jemermed.2026.07.018

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