Has anyone ever had a cervical block for their neck?

In performing a block of the cervical plexus( a nerve plexus formed by the anterior branches of the first four cervical nerves, supplying structures in the neck region.), it is important to keep in mind the relationship of palpable structures and landmarks to the transverse processes of the cervical vertebrae. There are two aspects of this block. The first involves blocking the roots of C2 to C4. The second part of the block, or superficial block, involves anesthetizing the nerves of the superficial cervical plexus as they emerge from the posterior border of the sternocleidomastoid muscle. The roots of cervical nerves 1 to 7 emerge superior to the transverse process of each cervical vertebra. In an adult, the larynx overlies cervical vertebrae 4 to 6 . The upper border of the larynx (C4) is palpable as the notch in the thyroid cartilage. The lower border of the larynx (C6) is the cricoid cartilage. Another landmark which can frequently help delineate the level of C6 is the point at which the external jugular vein crosses the posterior border of the sternocleidomastoid muscle. With the patients' head turned to the contralateral side, a line can be drawn from the cricoid cartilage to the point where the external jugular vein crosses the posterior border of the sternocleidomastoid. This will be at the level of C6. A line from the thyroid notch can be drawn parallel to the line for C6 to determine the level of C4.

To determine the position of the transverse process of C4, the mastoid process is located, and a mark is made 1cm posterior to it. A line is then drawn from this mark to intersect at right angles to the line drawn back from the thyroid cartilage for C4. Where these two lines cross is the location of the C4 transverse process. The location of C3 and C2 can be located quite easily once the position of C4 is known. This is done by following the line drawn from the mastoid process to C4 back up from C4 towards the mastoid, half of the distance between the C4 line and the C6 line to determine the position of C3 and the same distance again for C2.

After drawing out the positions of the transverse processes, the neck is prepped and draped. Using a 22 gauge 1.5 inch needle, the transverse processes are located by entering perpendicular to the skin. The depth of the transverse process varies with the body habitus of the patient. Once bone is contacted, the needle is pulled back slightly, and directed cephalad. This is repeated until the needle is walked off the bone. Moving cephalad will help assure that the needle is close to the desired nerve root. It is important to only walk off the bone a millimeter or two, because going any further can result in entering the subarachnoid space or the vertebral artery. After negative aspiration, 5cc of local anesthetic is injected slowly. This is repeated at the other two transverse processes. During injection, the patient should be communicated with continually, to help detect a change in mental status that could occur with intravascular injection.

I wish everything works out fine for you and there are no complications at all... take care.-