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J Emerg Med. 2018 Jul;55(1):87-95. doi: 10.1016/j.jemermed.2018.04.030. Epub 2018 May 29.

Use of Ultrasound-Guided Superficial Cervical Plexus Block for Pain Management in the Emergency Department.

Author information

1
Emergency Department, Nanaimo Regional General Hospital, Nanaimo, British Columbia, Canada; Department of Emergency Medicine, University of British Columbia, Nanaimo, British Columbia, Canada.
2
Department of Family Medicine, University of British Columbia, Nanaimo, British Columbia, Canada.

Abstract

BACKGROUND:

Although use of the superficial cervical plexus block (SCPB) by anesthesia for perioperative indications is well described, there is a paucity of research on use of SCPB in the emergency department (ED).

OBJECTIVE:

This prospective observational study aims to prospectively characterize the feasibility, potential for efficacy, and safety of ultrasound-guided SCPB in a convenience sample of ED patients presenting with painful conditions of the "cape" distribution of the neck and shoulder.

METHODS:

Data were gathered prospectively on a convenience sample of 27 patients presenting to a community ED with painful conditions involving the distribution of the SCPB: para-cervical muscle spasm/pain (n = 8), clavicle fractures (n = 7), acromioclavicular joint injuries (n = 3), radicular pain (n = 3), and rotator cuff disorders (n = 6). Pre- and post-block 11-point verbal numeric pain scores (VNPS) were recorded, as was the incidence of any immediate complications. A retrospective chart review looked for delayed complications in the 14-day post-block period.

RESULTS:

The mean 11-point VNPS reduction was 5.4 points (62%). There were no early serious complications and one case each of self-limiting vocal hoarseness and asymptomatic hemi-diaphragmatic paresis. No delayed block-related complications were found.

CONCLUSIONS:

While limited by the fact that this was a nonrandomized observational experience with no control group, our findings suggest that SCBP may be safe and have potential for efficacy, and warrants further evaluation in a randomized controlled trial.

KEYWORDS:

analgesia; cervical plexus; nerve block; ultrasound

PMID:
29858144
DOI:
10.1016/j.jemermed.2018.04.030
[Indexed for MEDLINE]

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