The Efficacy of Combined Superficial and Deep Cervical Plexus Block for Anterior Cervical Discectomy

Background: Major neck surgeries are conventionally performed under general anesthesia, but recent evidence suggests that regional anesthesia is an effective adjuvant to general anesthesia. The present study was designed to assess the efficiency of combined unilateral superficial and deep cervical plexus blocks with general anesthesia in patients undergoing anterior cervical discectomy. Methods: 30 patients undergoing to do anterior cervical discectomy surgery were divided into two group, general anesthesia group (GA); patient received general anesthesia alone, and combined group (GC); patients received combined general anesthesia and superficial and deep cervical blockade. Measurements were obtained which include intraoperative haemodynamics, intra and postoperative analgesic efficacy and hormonal stress response. Results: The number of patients requiring supplemental analgesic and muscle relaxant was lower in GC than GA group. The SBP and HR were significantly lower during intra and postoperative period in GC group than the base line and the other GA group. VAS was significantly lower in PACU in GC group than GA group but after 12 and 24 hours, there was no statistical difference between the two groups. The time of initial morphine administration was significantially longer in GC group then the GA group and the total morphine administration was significantly lower in GC group than in GA group. The blood glucose and Cortisol level were statistically significantly higher postoperatively compared to the base line. But this increase was clinically insignificant. Conclusion: Our results show that unilateral superficial and deep cervical plexus block performed with a 0.5% ropivacaine significantly reduced intraoperative requirements of anesthetics and analgesics in patients undergoing anterior cervical discectomy. And, the Postoperative analgesics were significantly reduced in combined group than the general anesthesia group.