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

Abstract

Pregnant patients with high-risk conditions including abnormal placentation or severe cardiovascular disease may require large-bore central venous access at the time of delivery. Central lines are generally inserted while obstetric patients are awake, either because neuraxial anesthesia is planned or to minimize fetal exposure to anesthetic medications. Despite local infiltration, the procedure can cause significant patient discomfort. This case series describes use of a superficial cervical plexus block (SCPB) to facilitate line placement in 4 pregnant women with high-risk conditions. SCPB is technically straightforward with low reported complication rates and should be considered for pregnant patients requiring large-bore central lines.

Regional anesthesia and analgesia for trauma: an updated review

“…Superficial cervical plexus block (SCPB) has been used for carotid endarterectomies, but use in the trauma population has been limited as opioids are the mainstay [36,37]. For patients who need tracheostomies or central venous catheters for internal jugular or subclavian vein access, placement often requires either sedation or general anesthesia [37]. One option is the use of SCPB to reduce systemic analgesia and discomfort to the patient.…”

“…One option is the use of SCPB to reduce systemic analgesia and discomfort to the patient. For a patient who has tenuous respiratory mechanics, where the use of sedation could be detrimental, SCPB offers an excellent alternative to systemic analgesia, providing pain relief without added respiratory complications [36,37].…”