So, i was doing intermediate and i was sure It was superficial!, can you explain better the indications( surgery) for each type of cervical plexus? I am a Little confused Thanks
Thank you. Always think about the purpose of the block and requirement of the patients. Consider the dermatome, myotome and osteotome of the involved surgical area. All these will help you to choose the block. For eg. 1. If you want to put a IJV central line, go with superficial Cervical Plexus Block. 2. If you want analgesia for neck dissection, go with intermediate cervical Plexus block. So on and so forth. Deep Cervical Plexus block we hardly use now.
Sorry Dr. Pradeep, I have no concrete data on this. The phrenic nerve involvement depends on the permeability of the Prevertebral fascia and how close the LA is spreading after the block. The incidence is variable, and the literature is scanty and inconclusive. Superficial: No Intermediate: possible Deep: yes
If you are doing it with ultrasound, level is the starting point only. You need to identify the anatomy and then act accordingly. No fixed rule. You can deposit LA for Intermediate block at c5 or c4 level also. Fascial layers and plane are important.
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Simple and clear explanation!! Thank you!
Thank you 😊
Thank you 🙏
Sooo helpful sir
Thank you
Crisp and crystal clear explanation!
Thank you
Excellent video presentation Sir ❤❤
Finally my wait is over
Thank you
Thank you very much Sir for putting so much hard work and efforts for making such wonderful videos
🙏🏻🙏🏻🙏🏻
Thank you for your kind words
So nice sir
Thank you
Thank you Sir, you are right, most other educators do not correctly illustrate the Scpb and Icpb
Thank you 😊
Nice description 😊
Thank you
is superficial sufficient for clavicle fracture analgesia
Clavicle is supplied by the following nerves:
Osteotome:
1. Supraclavicular (C3-C4)
2. Lateral pectoral (C5-C7)
3. Spinal Accessory (CNXI)
4. Nerve to subclavius (C5-C6)
5. Axillary (C5-C6)
6. Suprascapular (C5-C6)
Myotomes:
1. Axillary nerve (C5-C6)
2. Suprascapular nerve (C5-C6)
3. Lateral Pectoral nerve (C5-C7)
4. Nerve to subclavius (C5-C6)
5. Spinal accessory nerve (CN XI)
6. Trapezius branch of cervical nerves (C3-C4)
Dermatome:
1. Supraclavicular
2. Ventral Rami of C5
Superficial Cervical Plexus only covers Supraclavicular nerve.
What is about intermediate CPB, regarding area of coverage ?. @@DrTuhinM
If you are asking about clavicle coverage, it will be same as I mentioned above
Should we rely on cervical spine levels as mentioned in books for cervical plexus blocks or should we just rely on layers of cervical fascia or both??
If you are doing with ultrasound, start scan at the mentioned level and then go cephalad or caudad to achieve optimized image.
So, i was doing intermediate and i was sure It was superficial!, can you explain better the indications( surgery) for each type of cervical plexus? I am a Little confused
Thanks
Thank you.
Always think about the purpose of the block and requirement of the patients. Consider the dermatome, myotome and osteotome of the involved surgical area. All these will help you to choose the block.
For eg.
1. If you want to put a IJV central line, go with superficial Cervical Plexus Block.
2. If you want analgesia for neck dissection, go with intermediate cervical Plexus block.
So on and so forth.
Deep Cervical Plexus block we hardly use now.
Sir what is the incidence of phrenic nerve palsy in superficial and intermediate cervical plexus blocks??
Sorry Dr. Pradeep, I have no concrete data on this.
The phrenic nerve involvement depends on the permeability of the Prevertebral fascia and how close the LA is spreading after the block.
The incidence is variable, and the literature is scanty and inconclusive.
Superficial: No
Intermediate: possible
Deep: yes
You can go through these two articles for better understanding:
1. dx.doi.org/10.1136/rapm-2021-102851
2. doi: 10.1007/s00540-020-02770-2
@@DrTuhinM Thank you very much Sir
@@DrTuhinM Thank you Sir
Sir can you mention the levels at which superficial, intermediate and deep cervical plexus can be given i.e C4,C5 or C6 level??
I have mentioned in the video. Please watch the full video. Don't skip any part.
@@DrTuhinM Sir you mentioned C5-C6 level for superficial cervical plexus block is it so or is it for intermediate cervical plexus block??
@@SamtaniPradeep superficial and intermediate at same level
@@DrTuhinM ok sir
If you are doing it with ultrasound, level is the starting point only. You need to identify the anatomy and then act accordingly. No fixed rule.
You can deposit LA for Intermediate block at c5 or c4 level also. Fascial layers and plane are important.