A Clinical Study on Neck Surgeries Under Superficial Cervical Plexus Block as an Alternative to General Anesthesia in High-Risk Cases

摘要

To assess safety, efficacy, and feasibility of superficial cervical plexus block in neck surgeries as an alternative to general anesthesia in high-risk patients. The study was a comparative randomized control trial conducted for a period of 18 months. The target population was patients of high risk (ASA II/III) undergoing surgical intervention for neck pathologies. Sixty patients were chosen and randomized into 2 groups. Different neck surgeries in an anterior triangle and anterolateral neck were performed including lymph node excisions, incision and drainage, and hemithyroidectomies under ultrasound (USG)-guided superficial cervical plexus block (SCPB) in one group and under general anesthesia (GA) in the other group. Demographic factors, hemodynamic parameters, operating conditions, postoperative pain assessment, complications, and duration of hospital stay were compared between both groups. The study showed that USG-guided SCPB was easier to perform. It had minimal effect on hemodynamic parameters, provided excellent analgesia reducing the requirement of opioids/NSAIDs, and low complication rates when compared to GA. A few patients under SCPB required additional sedation so as to alleviate anxiety. Early feeding facilitated early recovery, and early ambulation contributed to reduce the duration of hospital stay. USG-guided SCPB is safe and effective with low complications for performing surgeries in patients who are especially at increased anesthetic risk but require prompt management of the pathologies in the anterior/anterolateral neck and is a good alternative to general anesthesia in anterior neck surgeries with good patient acceptability.