Clinical Indications
This section enhances the precision of targeted nerve blocks. Selecting the appropriate block for specific clinical scenarios ensures targeted anaesthesia, improving outcomes and patient comfort.​
​
Improved Postoperative Pain Control: Implementing regional anaesthesia effectively addresses postoperative pain, providing sustained relief and reducing the need for additional pain management.
​
Increased Procedural Safety: Tailoring the choice of block to each procedure lowers the risk of complications, especially in high-risk patients, and enhances the safety profile of surgeries.
Intermediate Cervical Plexus Block
Carotid Endarterectomy: Used for awake carotid endarterectomy or as perioperative analgesia following general anaesthesia, the intermediate cervical plexus block provides adequate pain control while allowing the patient to respond to neurological assessments. This is essential when monitoring cerebral function without compromising the patient's ability to participate in intraoperative monitoring.
Central Venous Catheter Insertion: This block facilitates the insertion of central venous catheters and vascaths through the internal jugular or subclavian veins. It provides sufficient anaesthesia to the insertion site, making the procedure more comfortable and less stressful, especially for awake patients. The block also eliminates the need for multiple skin punctures for local anaesthetics, reducing discomfort.
Clavicular Surgeries: The intermediate cervical plexus block is applicable for fracture repairs and other clavicular surgeries, as well as pain relief following clavicular fractures. It offers comprehensive pain relief, especially when combined with other blocks, such as the interscalene block. By targeting the supraclavicular branches of the cervical plexus, this block provides cutaneous analgesia.
Lymph Node Excision: This block is effective for lymph node excision within the anterior and posterior triangles of the neck. It reduces discomfort, improves patient tolerance, and ensures adequate anaesthesia for the surgical field by targeting the superficial cervical plexus nerves, which cover the skin and superficial tissues.
Tympanomastoid Surgery: Blocking the greater auricular nerve during this procedure can provide analgesia to the external ear and the area over the mastoid process. This helps reduce the need for systemic opioids and improves postoperative recovery.
Pinnaplasty (Otoplasty): For pinnaplasty, the intermediate cervical plexus block offers excellent anaesthesia to the external ear and promotes quicker recovery. It blocks the great auricular nerve, which supplies sensation to the ear and its surrounding areas.
Thyroid Surgery: This block allows for quicker recovery in thyroid surgery, particularly in high-risk patients. It provides effective anaesthesia for the incision and dissection areas, ensuring a smoother postoperative experience. However, careful monitoring is necessary to minimise the risk of complications, such as phrenic nerve involvement.
Tracheostomy: For tracheostomy procedures, the block provides perioperative pain relief by anaesthetising the skin and underlying tissues. However, care must be taken during bilateral blocks to avoid respiratory distress caused by potential phrenic nerve involvement.
Cervical Discectomy and Cervical Fusion Surgery: As part of a multi-modal analgesic technique, this block provides anaesthesia to the skin and superficial tissues. Deeper surgical infiltration is typically required for managing pain in deeper structures during cervical discectomy and fusion surgery.