Cervical Plexus Block

Question 1

What muscles are innervated by the cervical plexus?

Answer 1

The muscles of the neck.
Longnecker DE, Newman MF, Brown DL, Zapol WM.
Anesthesiology. 2nd ed. New York: McGraw-Hill; 2012: 828.

Question 2

From what spinal nerves is the cervical plexus

derived?

Answer 2

C2, C3, and C4
Longnecker DE, Newman MF, Brown DL, Zapol WM.
Anesthesiology. 2nd ed. New York: McGraw-Hill; 2012: 828.

Question 3

For what procedures are a cervical plexus block

useful?

Answer 3

It is excellent for carotid endarterectomy and supplementation
of the shoulder if needed following an interscalene block.
Longnecker DE, Newman MF, Brown DL, Zapol WM.
Anesthesiology. 2nd ed. New York: McGraw-Hill; 2012: 828.

Question 4

What is anesthetized by a superficial cervical plexus

block?

Answer 4

The skin of the neck, posterior shoulder, and superior shoulder.
The cervical plexus block is unique in that the sensory fibers
(superficial cervical plexus block) can be blocked separately
from the motor fibers (deep cervical plexus block).
Longnecker DE, Newman MF, Brown DL, Zapol WM.
Anesthesiology. 2nd ed. New York: McGraw-Hill; 2012: 828.

Question 5

What are potential complications of a deep cervical

plexus block?

Answer 5

Intravenous injection, spread of the local anesthetic into the
epidural or subarachnoid space, and blockade of the phrenic or
recurrent laryngeal nerves.
Longnecker DE, Newman MF, Brown DL, Zapol WM.
Anesthesiology. 2nd ed. New York: McGraw-Hill; 2012: 828

Question 6

What is the advantage of a cervical plexus block for

a patient undergoing carotid endarterectomy?

Answer 6

It allows the patient to be awake during the procedure which
provides the most accurate monitoring of neurologic status
during carotid cross-clamping. It does not adequately block the
carotid sinus reflex, however, and a local infiltration by the
surgeon may be necessary to achieve this.
Nagelhout JJ, Plaus KL. Nurse Anesthesia. 5th ed. St. Louis,
MO: Elsevier Saunders Company; 2014: 581.