LKnative – Superficial cervical plexus block

Indications for the superficial cervical plexus block

Superficial cervical plexus block is indicated for head and neck analgesia:

– Central venous cannulation

– Anterior neck surgery

– Thyroid surgery

– Shoulder surgery “cape of anaesthesia”

– Carotid endarterectomy (CEA) – the carotid artery is innervated by the vagus and glossopharyngeal nerves as well as sympathetic branches from the superior cervical ganglion which requires local anaesthetic injected in the carotid sinus region for surgical anaesthesia

– Clavicular fracture – combine superficial cervical plexus and brachial plexus blocks

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Indicated for analgesia after clavicular fracture surgery?

The innervation of the clavicle is controversial (ref. Tran et al, 2013)

Apparently, the supero-anterior aspect of the clavicle is innervated by the supraclavicular nerve from the superficial cervical plexus while the other parts of the clavicle are innervated by nerve branches from the brachial plexus: the suprascapular nerve and the long thoracic nerve (both from the superior trunk of the brachial plexus) – and maybe also the subclavian nerve

The sclerotomal innervation of the clavicle is traditionally ascribed to the C4 spinal nerve root

In 2/3 of human beings the C4 root contributes to the upper trunk of the brachial plexus; or maybe the sclerotomal innervation to the clavicle comes from the C4-C6 nerve roots