We conducted a study to evaluate the hypothesis that the preservation of cervical root branches of the cervical plexus
is associated with greater shoulder mobility, less loss of face and neck sensation, and better quality of life (QoL) following functional neck dissection in which the spinal accessory nerve is spared.
As per local standard practice, patients reporting pain in the shoulder in the postanesthesia care unit were evaluated by a physician and could receive a supplemental superficial cervical plexus
nerve block if appropriate.
Between 'sufentanil' and 'supraventricular tachycardia', adjacent entries in the index of the second edition, we now find 'sugammadex', 'superficial cervical plexus
block', 'cervical mediastinoscopy' and 'supraclavicular block'.
These include cutaneous branches of the cervical plexus
supplying the skin overlying the posterior triangle; the platysma and omohyoid muscles; the spinal accessory nerve, which innervates the SCM and trapezius muscles; the deep cervical lymph nodes; the brachial plexus; and numerous arteries and veins--prominent is the external jugular vein (see Figure 2).
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).
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.
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).
Three patients with localised distal paraesthesia and one patient with signs consistent with unintended cervical plexus
blockade were treated conservatively.
We describe a new technique for achieving a deep cervical plexus
block using a portable vascular access ultrasound scanner (Site ~ Rite[R] II, Bard Access Systems, Pittsburgh, PA).