What is the incidence of phrenic involvement with the combination of superior trunk and superficial cervical plexus block? I’d be hesitant to perform a bilateral block at this level.
It's a good question. The incidence with superior trunk is variable - ranges from 30-70% - ultimately it's all about spread, which is uncontrollable to some degree. I think that the risk of clinically-significant phrenic nerve palsy with a superficial cervical plexus block alone, if volumes are kept to 10ml or less are minimal. Hence I would personally be fine doing a bilateral SCP block for anterior neck surgery.
The deep cervical plexus block comes with a lot of collateral effects, since a higher chance of sympathetic block till motor block of muscles of the neck, for this cause being gradually abandoned in a few hospitals
It's semantics / terminology. Some people make a distinction between "superficial" = subcutaneous injection, and "intermediate" being injection another layer deeper under the superficial cervical fascia, as we would be doing when we inject under the edge of the muscle with US. I keep it simple personally, and only distinguish between superficial (which is either of these 2 variants) or deep (which is injection at the level of the roots), which I don't do (it's risky and difficult as the other commentator has noted).
@@KiJinnChin sir I have a doubt the difference between interscalene and supraclavicular brachial plexus block is that suprascapular nerve gets spared in supraclavicular block ... But some say suprascapular nerve is there within lateral part of bunch of grapes in supraclavicular region What is the basic diff between interscalene vs supraclavicular block? Sir
What is the incidence of phrenic involvement with the combination of superior trunk and superficial cervical plexus block? I’d be hesitant to perform a bilateral block at this level.
It's a good question. The incidence with superior trunk is variable - ranges from 30-70% - ultimately it's all about spread, which is uncontrollable to some degree. I think that the risk of clinically-significant phrenic nerve palsy with a superficial cervical plexus block alone, if volumes are kept to 10ml or less are minimal. Hence I would personally be fine doing a bilateral SCP block for anterior neck surgery.
Sir superficial vs intermediate cervical plexus block difference
The deep cervical plexus block comes with a lot of collateral effects, since a higher chance of sympathetic block till motor block of muscles of the neck, for this cause being gradually abandoned in a few hospitals
It's semantics / terminology. Some people make a distinction between "superficial" = subcutaneous injection, and "intermediate" being injection another layer deeper under the superficial cervical fascia, as we would be doing when we inject under the edge of the muscle with US. I keep it simple personally, and only distinguish between superficial (which is either of these 2 variants) or deep (which is injection at the level of the roots), which I don't do (it's risky and difficult as the other commentator has noted).
@@KiJinnChin sir I have a doubt the difference between interscalene and supraclavicular brachial plexus block is that suprascapular nerve gets spared in supraclavicular block ... But some say suprascapular nerve is there within lateral part of bunch of grapes in supraclavicular region
What is the basic diff between interscalene vs supraclavicular block? Sir