Superficial Cervical Plexus Block May Be Safe, Effective for Emergency Medicine Use

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Participants presented to the emergency department with painful conditions of the "cape" distribution of the neck and shoulder.
Participants presented to the emergency department with painful conditions of the "cape" distribution of the neck and shoulder.

Superficial cervical plexus block (SCPB) may be safe and effective for use in emergency medicine, according to results published in the Journal of Emergency Medicine.

The prospective observational study included participants who presented to the emergency department with painful conditions of the "cape" distribution of the neck and shoulder who were given SCPB (n=27). Verbal numeric pain scores on a 0 to 10 scale were recorded pre- and postblock, and the incidence of any immediate complications was examined.

Of all the participants, 8 had para-cervical muscle spasm/pain, 7 had clavicle fractures, 3 had acromioclavicular joint injuries, 3 had radicular pain, and 6 had rotator cuff disorders. Pain scores were reduced after SCPB by 5.4 points (62%).

No participants reported early serious complications. However, 1 participant reported self-limiting vocal hoarseness and another reported asymptomatic hemi-diaphragmatic paresis. The researchers did not find any delayed block-related complications in a 14-day follow-up period.

The study was limited because of its nonrandomized, observational design with no control group. However, the results warrant further research in a randomized controlled trial.

"Despite the absence of a direct comparator, our case series does seem to demonstrate a significant analgesic effect from the use of SCPB in dealing with a range of painful conditions involving the distribution of the superficial cervical plexus in [emergency department] patients," the researchers wrote.

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Reference

Ho B, De Paoli M. Use of ultrasound-guided superficial cervical plexus block for pain management in the emergency department. J Emerg Med. 2018;55:87-95.

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