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At least 19 recordsLinked to original sources
PubMed1991

Syndrome of the cervical plexus caused by high cervical nerve root compression.

Lesions affecting the roots of the cervical plexus can cause a syndrome not previously described. The C3-C4 disc space is the most likely to be involved, but pressure on the C5 root can also produce facial, auricular, or retroauricular pain. Motor innervation to the diaphragm can be affected, and even the uppermost disc space at C2-C3 might be implicated. Findings on examination findings are sparse, although sensory impairment in areas of cervical plexus innervation has been observed. In a series of 1000 cervical decompression cases (both anterior and posterior) for disc disease or similar processes, only 10 instances of this syndrome have been found. Paresthesia or episodic shock-like pain affecting the ear, para-auricular, lower occipital, and mandibular areas prompted by head turning or extension are the most common complaints.

Aged↗
PubMed1992

Extracapsular spread and the perineural extension of squamous cell cancer in the cervical plexus.

Extracapsular spread of squamous cell carcinoma in cervical lymph nodes is associated with approximately 50% decrease in survival and a twofold increase in regional recurrence. This study examines the hypothesis that increased regional recurrence may be, in part, due to unrecognized microscopic perineural invasion of the nerve rootlets of the cervical plexus. Thirty patients with head and neck squamous cell carcinoma with clinically N+ necks undergoing radical neck dissection were prospectively studied. Neck dissection specimens were evaluated for extracapsular spread, and the cervical plexus rootlets were histologically examined for perineural invasion. The incidence of extracapsular spread was 83% (25 of 30 patients). Only one (4%) of 25 had involvement of the cervical plexus, and this patient had gross as well as microscopic cervical plexus invasion. Microscopic perineural spread of squamous cell carcinoma in the cervical plexus occurs infrequently when extracapsular spread is present. Routine histologic evaluation of cervical rootlets for margins is warranted only when gross tumor is in close proximity to the cervical plexus.

Aged↗
PubMed2026

Superficial Cervical Plexus Block and Quality of Recovery after Thyroidectomy: A Randomized Clinical Trial.

BACKGROUND: Whether adding a bilateral superficial cervical plexus block to a thyroidectomy enhanced recovery pathway improves postoperative quality of recovery remains uncertain. METHODS: In a single-center prospective, randomized, double-blind, placebo-controlled trial in adults undergoing thyroidectomy with general anesthesia, participants were randomized to bilateral superficial cervical plexus blocks with 0.25% bupivacaine or saline. All participants received multimodal analgesia with dexamethasone, acetaminophen, nonsteroidal anti-inflammatory drugs, and incisional local anesthetic. The primary outcome was quality of recovery, measured by the QoR-40 survey, on postoperative day 1. Secondary outcomes included the need for rescue opioid, total opioid consumption, nausea, vomiting, antiemetic administration, length of stay in the postanesthesia care unit (PACU), and opioid use on postoperative day 1. RESULTS: A total of 160 participants were randomized to receive a superficial cervical plexus block with bupivacaine 0.25% (n = 78) or saline (n = 82). On postoperative day 1, mean QoR-40 scores were 174 (95% CI, 170 to 178) for bupivacaine and 173 (95% CI, 169 to 177) for saline. The adjusted mean difference between bupivacaine versus saline was 0.91 (95% CI, -3.57 to 5.40; P = 0.688). There were no significant between-group differences in the need for opioids in the PACU or on postoperative day 1, nausea, vomiting, or PACU length of stay. However, the total amount of opioid administered in the PACU was lower in the bupivacaine group (median [interquartile range], 0 [0 to 8]) compared with the saline group (2 [0 to 20]; Hodges-Lehmann location shift, 0 morphine milligram equivalents; 95% CI, -4 to 0; P = 0.017), and fewer participants in the bupivacaine group received rescue antiemetics (3 [3.8%] vs . 13 [16%]; difference, -12%; 95% CI, -22% to -1.8%; P = 0.011). CONCLUSIONS: Bilateral superficial cervical plexus blocks did not improve quality of recovery after thyroidectomy when added to a multimodal analgesic regimen including dexamethasone, acetaminophen, nonsteroidal anti-inflammatory drugs, and incisional local anesthetic but were associated with lower total PACU opioid consumption.

Humans↗
PubMedDate not supplied

Interscalene cervical plexus block: a single-injection technic.

A review of the anatomy of the cervical plexus and surrounding structures suggests a single-injection technic which simplifies anesthesia of the cervical plexus and increases the margin of safety in this procedure. Used by the authors, the technic has been successful in 97 percent of over 100 cases.

Anesthesia, Conduction↗
PubMed1992

Prevention of tachycardia with atenolol pretreatment for carotid endarterectomy under cervical plexus blockade.

A double-blind, randomised, controlled trial of forty patients was carried out to determine if oral atenolol pretreatment would reduce the incidence of tachycardia during carotid endarterectomy performed under cervical plexus block. Twenty patients received a placebo and twenty patients 50 mg of atenolol two hours prior to surgery. The superficial and deep cervical blocks were performed with 1.5% lignocaine containing 1:200,000 adrenaline. The patients were monitored with the V5 lead of the electrocardiogram and intra-arterial blood pressure. These measurements were recorded on a correctly calibrated paper recorder. Tachycardia (heart rate greater than 90 beats per minute for more than three minutes) occurred in thirteen patients in the placebo group and two patients in the atenolol group (P less than 0.01). There was no difference in the occurrence of bradycardia, hypotension or hypertension between the two groups. It is concluded that atenolol pretreatment is an effective method of reducing the incidence of tachycardia during carotid endarterectomy performed under cervical plexus blockade.

Aged↗
PubMed1990

The cutaneous cervical plexus nerves of the crab-eating macaque (Macaca fascicularis), eastern grey kangaroo (Macropus giganteus), and koala (Phascolarctos cinereus).

The origin, course and distribution of the cutaneous nerves of the cervical plexus were examined in the crab-eating macaque (4 body-halves), the grey kangaroo (5 body-halves) and koala (3 body-halves). The cutaneous nerves, n. auricularis magnus, nn. supraclaviculares, n. transversus colli, and n. transversus cervicis, were recognized. Cranial and caudal branches were identified in the latter 2 nerves. Some intermediate, relatively small branches were recognized between these main nerves. The n. occipitalis minor was not recognized in all our specimens. Four segmental nerves, C2 to C5, gave rise to all the cutaneous nerves and branches of the cervical plexus described. However, between species there was some variation. In the crab-eating macaque the n. auricularis magnus and n. transversus colli tended to arise from a lower segment than in the grey kangaroo and koala. In the grey kangaroo the nn. supraclaviculares arose from a lower segment than in the crab-eating macaque and koala.

Animals↗
PubMed2026

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

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.

Humans↗
PubMed1991

Arterial lignocaine concentrations following cervical plexus blockade for carotid endarterectomy.

Arterial lignocaine concentrations were measured in twenty-six patients who had carotid endarterectomy performed under deep and superficial cervical plexus blockade. A dose of 6 mg/kg of 1.5% lignocaine with 1:200,000 adrenaline was used, as well as additional supplementation by the surgeons when required. Concentrations obtained produced a mean peak of 5 micrograms/ml and were similar to those previously reported from multiple bilateral intercostal blockade, which is the regional technique widely considered to produce the highest systemic levels of local anaesthetic. Apart from one peak concentration of 16.9 micrograms/ml, levels were well below the convulsion threshold. We find the technique acceptable and safe for carotid surgery and lignocaine toxicity is not identified as a problem.

Aged↗
PubMedDate not supplied

[Carotid surgery with cervical plexus block: personal experience].

Although this is an unfrequently used technique, the authors report their early experience concerning twenty-seven cases of carotid artery revascularization under cervical plexus anesthesia. They express their surgical judgement about the advantages and the limits of the simplest and most reliable way of cerebral monitoring during the surgical procedure, but it might have only a limited indication.

Aged↗
PubMed1992

[Pauses in masseter innervation (silent periods) following stimulation of the median nerve, the cervical plexus and the mental nerve].

In 20 healthy volunteers, a bilateral masseter silent period (Mass SP) was constantly evoked by stimulating the mental nerve (latency: x = 13.95 +/- 4.3 ms) and cervical plexus (latency: x = 20.2 +/- 3.7 ms). This was also the case with median nerve stimulation (latency: x = 54.4 +/- 13.1 ms) in 19 of the 20 subjects. Utilizing magnetic stimulation of the lumbal roots, the Mass SP was elicited in 3 of 10 subjects and showed marked habituation. No Mass SP was observed with stimulation of the long nerves of the lower limbs. The central loop of the reflex represents a stable connection between the spinal cord cervical region and the trigeminal motor nuclei. The Mass SP may be abolished in circumscribed brainstem lesions and thus may serve for localizing lower brainstem involvement.

Adult↗
PubMed1992

[Anesthesia of the cervical plexus in surgical interventions on the neck and its organs].

The author proposes a new method for anesthesia of neck plexus, which is seen to be more safe, has reliable points of reference, and is administered by "one-touch" injection. The article gives a description of this method, results of its clinical application, indications and counter-indications. The anesthesia of neck plexus was applied on 71 patients. No complications were marked. This method makes it possible to produce an adequate anesthesia in vast operations on neck and its organs.

Adult↗