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At least 19 recordsLinked to original sources
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↗
PubMed1990

Carotid endarterectomy under cervical plexus block--a prospective clinical audit.

One hundred and twenty-eight patients having carotid endarterectomy under superficial and deep cervical plexus blocks were prospectively audited. The aim of the audit was to determine the incidence of intra-operative and postoperative neurological and cardiovascular complications and to establish patient acceptance of the technique. Twenty-seven patients who had intra-operative neurological changes following carotid artery clamping responded to shunt insertion. Six patients had transient neurological changes after the operation but there were no permanent neurological complications. Tachycardia (55%) and hypertension (67%) were the most common intra-operative cardiovascular changes and there was one clinical postoperative myocardial infarction. Ninety-two per cent of patients who could be adequately assessed preferred to have the same method of anaesthesia for future carotid endarterectomy. The authors concluded that carotid endarterectomy under superficial and deep cervical plexus blocks was associated with a high patient acceptance, low neurological complication rate and an acceptable rate of cardiovascular complications.

Aged↗
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↗
PubMed1990

The use of combination cervical plexus block and general anesthesia for radical neck dissection in a patient with severe chronic obstructive pulmonary disease.

Patients with severe chronic obstructive pulmonary disease (COPD) who receive a general anesthetic are at increased risk for postoperative pulmonary complications; therefore, it is desirable to avoid or to limit the dose of general anesthesia in these patients. Regional anesthesia, or a combination of regional and light general anesthesia, is an ideal choice for achieving this goal. This case report demonstrates how we used cervical plexus blocks in combination with light levels of general anesthesia for radical neck dissection in a patient with severe COPD.

Aged↗
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↗
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↗
PubMed1991

A complete regional anesthesia technique for cardiac pacemaker insertion.

Sixteen consecutive adult patients scheduled for permanent transvenous cardiac pacemaker insertion received as their total anesthetic the combination of a cervical plexus block and blocks of the second, third, and fourth intercostal nerves using a combination of 1% mepivacaine and 0.2% tetracaine with epinephrine, 1:200,000. This technique consistently provided complete surgical anesthesia of the third cervical (C3) through the fourth thoracic (T4) dermatomes, without anesthesia of the brachial plexus. Anesthesia was adequate for the surgical procedure without the need for supplemental analgesia or anesthesia in all cases. Because fluoroscopy was used routinely for the surgical procedure, it was possible to document that there were no instances of diaphragmatic paralysis or pneumothorax. In contrast to other reports, this technique provides surgical anesthesia that is adequate for all of the approaches used for transvenous pacemaker implantation, except for placement of a battery in an abdominal pouch. There were no serious complications and/or side effects in any of the patients studied.

Aged↗
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↗
PubMed1979

Hand-held toy squeaker during carotid endarterectomy in the awake patient.

A toy squeaker held by the patient in the contralateral hand is used to monitor cerebral circulation during carotid endarterectomy. Regional anesthesia--cervical plexus block--allowed the patient to cooperate and give useful information, especially during the crucial period of test clamping. In a series of 300 cases, during a period of five years, it was instrumental in avoiding brain damage in 6% of the cases.

Anesthesia, Conduction↗
PubMed1991

[Effectiveness of regional anesthesia for loco-regional carotid surgery. Retrospective review of 147 interventions].

The Authors present a retrospective review that compares general anesthesia with regional anesthesia performed during carotid endarterectomy surgery. The study includes 147 procedures, performed on 144 patients: 76 had general anesthesia and 71 had regional anesthesia. After emphasizing the importance of conscience preservation during regional anesthesia to allow a simple and secure monitoring of the patient's neurologic functions, the Authors point out the decrease of peri- and postoperative accidents, whether neurologic or not, obtained with regional anesthesia. Another essential advantage of this technique is the possibility to insert the transitory shunt only when objectively necessary, ulteriorly reducing neurologic complications. Cervical plexus block is primarily indicated for high risk patients with instable neurologic simptomatology, severe stenosis of the contralateral carotid, coronary heart disease. The technique has proved to be of easy execution, safe and well accepted by the patient and the surgeon.

Aged↗
PubMed1990

[The relations between acupuncture analgesia and changes of concentration of serum metallic ion].

Forty patients treated by thyroidectomy received superficial cervical plexus block or electric acupuncture stimulation of acupoint Hegu and Neiguan bilaterally. All patients were random divided into groups of C, A1, A2 and A3 on the basis of anesthetic method. Every patients were measured their serum concentration of Na+, K+, Ca++, Cu++, Mg++ and Zn++ before and during anesthesia or electric acupuncture stimulation and postoperation. There was no difference about analgesic effect of four groups (P greater than 0.05). Serum Ca++ concentration reduced various level during electric acupuncture stimulation (P less than 0.05-0.01), but no difference between group A1 and group A2 (P greater than 0.05). The results showed: 1. It made level of serum Ca++ reduced because internal environment of patients were affected by the signal of acupuncture. 2. There was no addition effect for the influence of serum Ca++ when electric acupuncture stimulated points Hegu and Neiguan at the same time intravenous injected Pethedine (1.3 mg/kg). 3. It probably disturbed the value of serum Ca++ concentration when intravenous injected 5% Glucose during the operation, but it had not influence on analgesic effect. 4. Acupuncture probably made concentration of serum Na+, Cu++, Mg++ and Zn++ changed which had statistical difference but with marked irregular figure, the real causes are worth going further into research in future.

Acupuncture Analgesia↗
PubMed1979

[Evaluation of brachial plexus block. Comparison between supraclavicular and interscalene approach (author's transl)].

A scheme for evaluating brachial plexus block was developed, which is based on anatomical structures and which utilizes simple neurological examination techniques. It facilitates the localization of the tip of the cannula near the plexus, gives an idea of the spread of the local anesthetic in the region of the trunks and cords, gives well timed judgement on the success of the block and allows a comparison of the development of the block when using various techniques. Using this scheme, the development of the block was examined following use of the supraclavicular and interscalene approach. With the supraclavicular technique, motor as well as sensory blockade of all nerves of the brachial plexus occurred with about the same frequency; with the interscalene technique, the centre of the block affected the caudal nerves of the cervical plexus and the cranial nerves of the brachial plexus. Following both approaches, the blockade developed from proximal to distal areas, the motor blockade preceding the sensory blockade.

Brachial Plexus↗
PubMed1991

Somatosensory evoked potentials are unchanged by reflex sympathetic dystrophy and by stellate ganglion block.

Median nerve somatosensory evoked potentials (SEPs) were monitored in patients with chronic pain before and after stellate ganglion blockade. A change caused by the syndrome or by the block would suggest that SEPs might be useful in the diagnosis and treatment of chronic pain. We observed 20 subjects. Group I (n = 10) had chronic pain not involving the upper extremity. Group II (n = 8) had reflex sympathetic dystrophy of the arm. All patients underwent unilateral stellate ganglion block using an anterior paratracheal approach. The SEPs were recorded by median nerve stimulation on the blocked (affected) side and unblocked (unaffected) side before and 30 min after the block. Recording sites were ipsilateral brachial plexus, the cervical spinal cord, and the contralateral sensory cortex. There were no between-group differences before or after the block. Paired analysis within each group showed that the SEPs were not different from baseline (unaffected side before block) at any time throughout the study. We conclude that since SEPs are not changed by the reflex sympathetic dystrophy or stellate ganglion block, they would not be useful in the evaluation of pain or in determining the effectiveness of sympathetic block. Both the pain and the block appear to involve alteration of conducting pathways separate from those monitored by median nerve SEPs.

Adolescent↗
PubMed1992

[A study of cerebral circulation following cervical sympathetic ganglion block].

Cerebral circulation following cervical epidural block or stellate ganglion block at the transverse process of the 6th cervical vertebra (C6-SGB) was evaluated by single photon emission computed tomography of inhaled Xenon-133. Cerebral blood flow before and 15 min after both blocks was measured in eight patients after cervical epidural block and ten patients after C6-SGB. Cerebral blood flow decreased slightly following cervical epidural block, but it was not a statistically significant difference. Cerebral blood flow following C6-SGB could be separated into two groups; in one it increased and in the other it decreased slightly. In conclusion, cerebral circulation is not influenced by cervical epidural block, but it is probably affected by C6-SGB. The manner in which C6-SGB increases cerebral blood flow seems that local anesthetics reached the superior cervical ganglion and block it. C6-SGB without superior cervical ganglion block does not influence cerebral circulation, and it only dilates extracranial vessels.

Adult↗
PubMed1979

Clinical report: interscalene block for shoulder operations.

Administration of adequate volumes of local anaesthetic through a single injection into the interscalene space produces blockade of both the brachial and cervical plexuses. A report of 2 patients who underwent operative repair of recurrent dislocation of the shoulder under interscalene block is presented. The advantages and disadvantages of the block for surgery around the shoulder region, and the possible complications are discussed.

Adult↗
PubMedDate not supplied

[The debridement of submandibular abscesses under locoregional block].

The efficiency of analgesic block of the inferior alveolar, auriculotemporal, lingual, buccal and superficial cervical plexus in patients requires debridement of unilateral submandibular abscess has been investigated. The technique was significantly more useful (p < 0.001) when compared with other analgesic block techniques utilized in these cases. This treatment can be performed in any medical office with minimal resources and be of use as an alternative for general anesthesia.

Abscess↗