Transverse Cervical Nerve for Landmark-Guided Cervical Cutaneous Analgesia

Area of Science:

• Anatomy
• Pain Management
• Regional Anesthesia

Background:

• Neck injections can be painful, even with topical anesthesia.
• Blocking the transverse cervical nerve (TCN) may improve patient comfort.
• Practical surface landmarks are needed for TCN blocks, with awareness of the external jugular vein (EJV).

Purpose of the Study:

• To identify a reliable surface landmark for TCN block.
• To evaluate the efficacy of a landmark-guided TCN block in reducing injection pain.
• To assess the safety of the TCN block technique.

Main Methods:

• Anatomical mapping of TCN emergence point on 46 heminecks using SCM landmarks.
• A pilot study (n=9) compared landmark-guided TCN block with topical lidocaine cream.
• Pain was assessed using a visual analog scale (VAS).

Main Results:

• The TCN emerged at a mean of 53% along the SCM reference line.
• Complete cutaneous anesthesia was achieved in all 9 participants.
• VAS pain scores were significantly lower on the TCN block side (p=0.0039).

Conclusions:

• A proportional SCM landmark (approx. 53%) provides a simple guide for TCN block.
• Landmark-guided TCN block effectively reduces discomfort during neck injections.
• Awareness of the EJV and aspiration are crucial for safe TCN block procedures.