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Postoperative Analgesic Efficacy and Safety of Cervical Cervicis Plane (CCeP) Block for Posterior Cervical Spine
Fang Yu1, Jeffrey Tang2, Omar Gobji3
1Department of Neurology, Westchester Medical Center.
Study Design:
A retrospective, single-center study.
Objective:
Evaluate the efficacy and safety of cervical cervicis plane (CCeP) block in reducing postoperative pain and opioid use in adult patients undergoing posterior cervical spine (PCS) surgery.
Summary Of Background Data:
PCS surgery is associated with significant postoperative pain due to the dissection of paraspinal muscles responsible for cervical posture, stability, and head activity. The CCeP block is a regional anesthesia technique aimed at improving postoperative pain control after PCS surgery, while reducing opioid consumption.
Methods:
A retrospective study of adult patients who underwent PCS surgery from October 18, 2020, to April 30, 2025, at a single center was conducted. A total of 236 consecutive cases were identified, and complete data extraction was performed manually using the EMR. Patients were assigned to the CceP or control groups based on whether the block was administered. Data collected included demographics, perioperative parameters, pain scores and opioid consumption at 6, 12, 24, and 48 hours postoperatively, time to first rescue opioid administration and incidence of opioid-related side effects and length of stay. Statistical analyses were performed to compare outcomes between the 2 groups.
Results:
The CCeP block group had significantly lower pain scores at 6 hours [5 (0-7) vs. 6 (5-9), P=0.001] and reduced opioid consumption at 6 hours [0.18 (0.07-0.35) MME/kg vs. 0.27 (0.14-0.43) MME/kg, P=0.0076] and 12 hours [0.30 (0.13-0.47) MME/kg vs. 0.36 (0.20-0.58) MME/kg, P=0.0304] postoperatively. The CCeP block group had a longer time to first rescue opioid administration [53 (24.0-157.5) vs. 33 (16.5-77.5) min, P=0.0035], and a shorter hospital stay [3 (2-5) vs. 5 (3-8) d, P=0.004]. In addition, the CCeP block did not affect intraoperative neuromonitoring signal acquisition.
Conclusion:
The CCeP block is a safe and effective technique for reducing early postoperative pain in PCS surgery without affecting intraoperative neuromonitoring signals. It provides modest analgesic benefit primarily within 12 hours after surgery. Although statistically significant reductions in early opioid requirement were observed, the clinical magnitude is limited and should be interpreted within a multimodal analgesia context. Prospective randomized controlled trials with standardized anesthetic regimen, and controlling for surgery extent/duration are required to validate the clinical significance of these findings.
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