A cervical nerve block approach to improve safety

Area of Science:

• Interventional Pain Management
• Anesthesiology
• Radiology

Background:

• Selective cervical nerve blocks are common procedures.
• Ensuring accurate needle placement and injectate spread is crucial for efficacy and safety.
• Previous techniques may lack continuous monitoring capabilities.

Purpose of the Study:

• To describe a novel technique for selective cervical nerve block.
• To enable continuous monitoring of injectate passage.
• To verify needle tip position during the procedure.

Main Methods:

• A technique involving a short connecting tube, contrast material mixed with the final injectate, and fluoroscopy was used.
• 560 selective cervical nerve block injections were performed.
• Cadaveric specimens were used to illustrate faulty needle placement.

Main Results:

• The described technique allows for continuous monitoring of injectate spread.
• Fluoroscopy, particularly a true lateral view, aids in identifying dangerous anterior needle tip placement.
• The technique was applied in 560 injections between January 2004 and May 2006.

Conclusions:

• Continuous monitoring of injectate flow and needle position enhances the safety of selective cervical nerve blocks.
• A true lateral fluoroscopic view is essential for detecting anterior needle misplacement.
• Further safety measures include pre-procedure anesthetic/contrast testing and using water-soluble steroids.