To facilitate awake endotracheal intubation, a blockade of the glossopharyngeal, superior laryngeal, and recurrent laryngeal nerves can be utilized. The peripheral blockade of nerves in the neck is most often used to facilitate awake endotracheal intubation for the patient with a difficult airway. Although topicalization with minimal-to-moderate sedation is often sufficient to perform an awake intubation, one should be knowledgeable of all the alternative methods should the need arise. This chapter focuses on the indications, relevant anatomy, and complications of these blocks. Also described is blockade of the cervical plexus, which is useful in facilitating surgery on more superficial neck structures.

Regional anesthesia for procedures involving the head can be easily achieved through the careful application of peripheral nerve blockade. Because the head has predictable surface and bony landmarks, the blocks can easily be placed pre- and intraoperatively to provide both regional anesthesia and postoperative analgesia with minimal complications. The peripheral blockade of nerves involving the head can provide perioperative anesthesia as well as management of both perioperative pain and chronic pain. The purpose of this chapter is to provide information and recommendations on how to best perform these blocks as well as describe their indications, complications, and relevant surrounding anatomy.

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Chronic pain disorders present with different etiologies and consequently their signals are carried by different classifications of nerve fibers. Syndromes and disorders that present with sympathetically based pain are therefore treated differently than those with more musculoskeletal based etiologies. Autonomic nerve blockade primarily targeting sympathetic nerve ganglia can be used to provide significant pain relief in certain chronic pain disorders, most notably complex regional pain syndrome. Commonly targeted sympathetic ganglia include the stellate, celiac, and lumbar sympathetic chains. The purpose of this chapter is to provide recommendations on how to best perform these blocks as well as describe their indications, possible complications, and relevant surrounding anatomy.