Superficial or Combined Deep and Superficial Cervical Plexus Block for Carotid Endarterectomy

Pandit, J J; McLaren, Ian D.; Crider, Bruce A.

doi:10.1097/00000539-199902001-00096

Cited by 7 publications

(7 citation statements)

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“…The SCP block has been well described for anesthesia of the neck, submandibular area, and the ear lobe and is potentially useful for patients with ear lobe lacerations, submandibular abscesses, or injuries to the neck. Its application in oral and maxillofacial surgical (OMFS) has been in surgical drainage of an abscess in perimandibular region, excisions of superficial lesions, and skin suturing in the corresponding dermatome [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

The Safety and Effectiveness of Superficial Cervical Plexus Block in Oral and Maxillofacial Surgery as an Alternative to General Anesthesia in Selective Cases: A Clinical Study

Hakim

Shah

Teli

et al. 2017

J. Maxillofac. Oral Surg.

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Aim To assess the safety and effectiveness of superficial cervical plexus (SCP) block in oral and maxillofacial surgical (OMFS) practice as an alternative to general anesthesia in selective cases. Subjects and Methods The total number of patients was 10, out of which 6 were male and 4 were female patients. Five patients had incision and drainage of perimandibular space infections, two patients had enucleation of cyst in the body of mandible, one patient had open reduction and internal fixation isolated angle fracture, and two patients had submandibular lymph node biopsies. Informed & written consent were obtained from the patients after they had the procedure explained to them. Medically compromised patients and those who were excessively anxious and apprehensive, patient who did not want the procedure to be done under regional anesthesia, and patients with a history of allergy to local anesthetic were excluded. All patients had their surgical procedures under regional anesthesia (SCP block with supplemental nerve blocks) performed by the same surgeon under the supervision of anesthesiologist with continuous monitoring. Results SCP block with concomitant mandibular nerve and long buccal nerve block has a high success rate, low complication rate, and high patient acceptability as shown in the study. Conclusion Superficial cervical plexus block anesthesia is a safe and useful anesthetic technique with the low risk of accidents and complications, thus a good alternative for regional anesthesia in selected cases in oral and maxillofacial surgery.

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Section: Introductionmentioning

confidence: 99%

The Safety and Effectiveness of Superficial Cervical Plexus Block in Oral and Maxillofacial Surgery as an Alternative to General Anesthesia in Selective Cases: A Clinical Study

Hakim

Shah

Teli

et al. 2017

J. Maxillofac. Oral Surg.

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“…The superficial cervical plexus (SCP) block is frequently used in a variety of disciplines such as in thyroidectomy, carotid endarterectomy, vocal cord surgeries, and cervicogenic painful syndromes. [ 2 3 4 ] Its application in oral and maxillofacial surgical (OMFS) has been in surgical drainage of an abscess in perimandibular region, excisions of superficial lesions, skin suturing in the corresponding dermatome. [ 5 ] Anatomic studies of the spread of injectate with SCP block in humans suggest that the LA crosses the deep cervical fascia and blocks the cervical nerves at their roots that is SCP innervates the skin of anterolateral neck.…”

Section: Introductionmentioning

confidence: 99%

The use of superficial cervical plexus block in oral and maxillofacial surgical practice as an alternative to general anesthesia in selective cases

Kanthan

2016

Ann Maxillofac Surg

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Aim:(1) To assess the feasibility, safety, and effectiveness of superficial cervical plexus (SCP) block in oral and maxillofacial surgical (OMFS) practice as an alternative to general anesthesia in selective cases. (2) To assess any associated complication specifically related to the procedure.Subjects and Methods:The total number of patients was 10, out of which 6 were male and 4 were female patients. Six patients had incision and drainage of perimandibular space infections, two patients had Level Ib cervical lymph node biopsies, one patient had enucleation of cyst in the body of mandible, one patient had open reduction and internal fixation isolated angle fracture. Informed written consent was obtained from the patients after they had the procedure explained to them. Exclusion criteria included patient's refusal to undergo the procedure under regional anesthesia, allergy to local anesthetic, excessively anxious, and apprehensive patients, significant upper airway compromise warranting an endotracheal intubation to secure airway. All patients had the procedure done by the same operating surgeon. All patients had their surgical procedures under regional anesthesia (SCP block with supplemental nerve blocks) performed by the same surgeon with satisfactory anesthesia and analgesia without any complication.Results:SCP block with concomitant mandibular nerve and long buccal nerve block has a high success rate, low complication rate, and high patient acceptability as shown in the study.Conclusion:The notable anesthetic effect and adequate working time, summed with the low risk of accidents and complications, make this technique a good alternative for sensitive blockage of part of the cranial and cervical regions and have positive outcomes in selective OMFS cases.

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“…However, it has been suggested that complications of the technique are related to the deep injection and not the superficial (or intermediate) injection. 81 These complications include intrathecal or intravascular injection, respiratory problems related to phrenic nerve paralysis, or local anaesthetic toxicity. Nonetheless, after recently describing two complications using the deep cervical plexus block, Carling and Simmonds 18 stated explicitly that 'the safest cervical block has not yet been established', so the issue is one which indeed warrants more definitive evidence.…”

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confidence: 99%

Superficial or deep cervical plexus block for carotid endarterectomy: a systematic review of complications †

Pandit

Satya-Krishna

Gration

2007

British Journal of Anaesthesia

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219

147

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Carotid endarterectomy is commonly conducted under regional (deep, superficial, intermediate, or combined) cervical plexus block, but it is not known if complication rates differ. We conducted a systematic review of published papers to assess the complication rate associated with superficial (or intermediate) and deep (or combined deep plus superficial/intermediate). The null hypothesis was that complication rates were equal. Complications of interest were: (1) serious complications related to the placement of block, (2) incidence of conversion to general anaesthesia, and (3) serious systemic complications of the surgical-anaesthetic process. We retrieved 69 papers describing a total of 7558 deep/combined blocks and 2533 superficial/intermediate blocks. Deep/combined block was associated with a higher serious complication rate related to the injecting needle when compared with the superficial/intermediate block (odds ratio 2.13, P = 0.006). The conversion rate to general anaesthesia was also higher with deep/combined block (odds ratio 5.15, P < 0.0001), but there was an equivalent incidence of other systemic serious complications (odds ratio 1.13, P = 0.273; NS). We conclude that superficial/intermediate block is safer than any method that employs a deep injection. The higher rate of conversion to general anaesthesia with the deep/combined block may have been influenced by the higher incidence of direct complications, but may also suggest that the superficial/combined block provides better analgesia during surgery.

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Superficial or Combined Deep and Superficial Cervical Plexus Block for Carotid Endarterectomy

Cited by 7 publications

References 0 publications

The Safety and Effectiveness of Superficial Cervical Plexus Block in Oral and Maxillofacial Surgery as an Alternative to General Anesthesia in Selective Cases: A Clinical Study

The Safety and Effectiveness of Superficial Cervical Plexus Block in Oral and Maxillofacial Surgery as an Alternative to General Anesthesia in Selective Cases: A Clinical Study

The use of superficial cervical plexus block in oral and maxillofacial surgical practice as an alternative to general anesthesia in selective cases

Superficial or deep cervical plexus block for carotid endarterectomy: a systematic review of complications †

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