Introduction. General anesthesia is frequently employed in neck surgery
procedures. However, in patients at high risk for general anesthesia,
regional anesthesia options, such as the superficial cervical plexus block,
warrant careful consideration. Patients with mediastinal lymph node
enlargement face an elevated risk of airway obstruction and hemodynamic
mediastinal instability during anesthesia induction. In selected neck
surgeries, including thyroglossal cyst excision, thyroglossal fistula
repair, bronchial cyst removal, thyroidectomy, and lymph node excision, the
superficial cervical plexus block presents a viable and secure alternative
to general anesthesia. Case report. This report details the case of a
patient with mediastinal lymphadenopathy and multiple brain metastases who
underwent cervical lymph node excision. Given the patient?s severe
comorbidities, pronounced risk of complete distal airway obstruction,
hemodynamic instability, and the potential for compression effects from
mediastinal mass, a superficial cervical block was administered. This block
facilitated effective perioperative analgesia without inducing respiratory
or cardiovascular instability. Conclusion. The superficial cervical plexus
block emerges as a prudent alternative to general anesthesia in high-risk
patients necessitating cervical lymph node excision procedures. Its
utilization should be considered in such cases to enhance patient safety and
perioperative management.