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Superficial Cervical Plexus Nerve Block
Aka: Superficial Cervical Plexus Nerve Block, Ultrasound-Guided Cervical Plexus Block, Cervical Plexus Block
- Indications
- Anesthesia to anterolateral neck from clavicle to inferior and lateral ear
- Catheterization of Internal Jugular Vein
- Clavicle Fracture
- Laceration Repair
- Anatomy
- Superficial Cervical Plexus (C2-4) supplies four superficial periopheral nerves
- Lesser Occipital Nerve
- Greater Auricular Nerve
- Transverse Cervical Nerve
- Suprclavicular Nerve
- Risk of adverse effects on nearby structures
- Carotid Artery and Internal Jugular Vein are medial to injection site
- Brachial Plexus is inferior to injection site
- Cervical plexus is deep to injection site
- Preparation
- Identify and mark landmarks
- Lateral neck (posterior aspect of sternocleidomastoid)
- Level of superior aspect Thyroid cartilage
- Skin Preparation (e.g. Chlorhexidine)
- Drape region
- Sterile covering over Ultrasound high frequency linear probe (sterile gel inside and outside)
- Medication
- Confirm maximum dose for Ropivacaine (or Bupivacaine ) to prevent LAST Reaction
- Ropivacaine 0.5% (preferred over Bupivacaine 0.25% to 0.5%) 10-15 ml
- Syringe 10-20 ml
- Needle 25-27 gauge, 1.25 to 1.5 inch
- Technique
- Ultrasound in transverse plane over lateral neck
- High frequency linear probe
- Roughly at level of superior aspect Thyroid cartilage
- Probe overlies posterior aspect of sternocleidomastoid Muscle
- Injection Plane
- Inject from lateral to medial
- Under the lateral border of the sternocleidomastoid Muscle
- Target is 1-2 cm deep between sternocleidomastoid Muscle and levator Scapulae Muscle
- Posterior aspect of Sternocleidomastoid Muscle (superficial)
- Plane containing the Superficial Cervical Plexus
- Levator Scapulae Muscle (deep)
- Images

- Adverse Effects
- Recurrent laryngeal nerve transient paralysis (hoarse voice)
- Brachial Plexus Block (resulting arm motor and sensory effects)
- Horner's Syndrome
- LAST Reaction (as with any Nerve Block)
- References
- Hipskind (2020) Cervical Plexus Block, Stat Pearls, accessed 12/21/2020
- https://www.ncbi.nlm.nih.gov/books/NBK557382/
- Martel (2020) Regional Anesthesia for Acute Care Conference, attended 12/11/2020
- https://stabroom.com/
- Ultrasound Guided Cervical Plexus Block, NYSORA, accessed 12/21/2020
- https://www.nysora.com/techniques/head-and-neck-blocks/cervical/ultrasound-guided-cervical-plexus-block/