A minimally painful, comfortable, and safe technique for hemodialysis catheter placement in children: Superficial cervical plexus block

Abstract

The superficial cervical plexus block (SCPB) is utilized in pediatric patients to perform certain surgical procedures, but there is no evidence supporting its use in hemodialysis catheter placement. We evaluated the analgesic effectiveness, intraoperative complications, and patient satisfaction associated with SCPB for pediatric patients in renal failure undergoing emergent dialysis catheterization. A total of 52 patients ranging from 1 to 17 years old that required emergent dialysis catheter placement and received SCPB were included in this study. During the catheterization, intraoperative pain scores, requirement for additional analgesia, catheterization access site, and intraoperative complications were recorded. The Children's Hospital of Eastern Ontario Pain Scale (mCHEOPS) was used to determine pain ratings during skin puncture with the needle, skin dilatation, and securing the catheter with stitches. The patients had an average age of 8.46 ± 5.3 years. The preferred catheterization entry site was through right internal jugular vein, which was achieved in 80.7% of patients. However, 19.3% of patients required access through the right subclavian vein. The average mCHEOPS score during skin puncture was 1.4 ± 0.5, and the mean mCHEOPS score was 2.3 ± 0.6 for skin dilatation. Finally, the average mCHEOPS score while securing the catheter with stitches was 1.3 ± 0.4. No patient required fentanyl for additional analgesia. No intraoperative complications occurred. The benefits gained from using SCPB performed by an experienced anesthesiologist for hemodialysis catheter placement include providing sufficient analgesia and optimal surgical conditions while avoiding the complications associated with general anesthesia for pediatric patients with renal failure.

Local Anesthesia for Port Catheter Placement in Oncology Patients: An Alternative to Landmark Technique Using Ultrasound-Guided Superficial Cervical Plexus Block—A Prospective Randomized Study

“…They form the sensory fibers of these regions [18–20] (Figures 7(a)–7(b) show the domain of the plexus) (Figure 7). Çiftci et al [19] reported that when SCPB was used prior to the insertion of a hemodialysis catheter into either IJV or SV, patients had low pain scores during the procedure and the block was successful and did not require additional sedoanalgesia in any patient. Ben Ho et al [20] reported that they performed SCPB in the cervical fractures, paracervical muscle spasm, acromioclavicular joint injuries, and rotator cuff disorders in the emergency department and obtained significant analgesic results.…”

Ultrasound-Guided Combined Interscalene-Cervical Plexus Block for Surgical Anesthesia in Clavicular Fractures: A Retrospective Observational Study

“…Ultrasound-guided superficial cervical plexus blocks are found to be successful for treating pain in emergency care settings [ 9 ]. Superficial cervical plexus blocks can also be used to provide surgical anesthesia for lymph node biopsy and excision of a thyroid nodule and placement of hemodialysis catheters [ 20 , 21 ]. Ultrasound-guided bilateral cervical plexus blocks could be performed for postoperative analgesia following thyroid surgeries [ 22 ].…”

Superficial Cervical Plexus Block for Awake Large-Bore Central Line Placement in Parturients: A Case Series

“…Superficial cervical plexus block (SCPB) has been described for tunneled central venous catheters (CVCs) in awake patients, 1 hemodialysis catheter placement in pediatric patients, 2 and awake invasive neck surgeries including carotid endarterectomy 3 and thyroidectomy. 4 To our knowledge, there have been no reports of the use of SCPB in obstetric patients to facilitate central line placement.…”