Superficial Cervical Plexus

by | Jun 19, 2021

Indications

  • Clavicle fractures
  • Laceration repair
  • Internal jugular central lines

Contraindications

  • Infection overlying injection site
  • Allergy to local anesthetic
  • Distortion of anatomical landmarks

Equipment

  • 2-5cc of local anesthetic of choice
  • Syringe
  • Saline Flush
  • Cleansing solution
  • Ultrasound with linear transducer
  • Ultrasound transducer sterile cover

Preparation

Positioning

Place patient in supine position

Ultrasound

Landmarks

  1. Place transducer in transverse orientation at the superior pole of the thyroid cartilage

SCM: Sternocleidomastoid

  1. Identify labelled landmarks
    1. Internal jugular vein (IJ)
    2. Carotid artery (CA)
    3. Sternocleidomastoid muscle (SCM)
  2. Translate lateral to identify the fascial plane just inferior to the sternocleidomastoid muscle and above the levator scapulae muscle (LSM) which contains the superficial cervical plexus

Technique

  1. In-plane needle visualization
  2. Lateral-to-medial approach with slow injection of anesthetic in the fascial plane between SCM and LSM

Source

  1. Highland Ultrasound