An anatomical basis for blocking of the deep cervical plexus and cervical sympathetic tract using an ultrasound-guided technique.
BACKGROUND
A selective blocking method for the cervical plexus and the cervical sympathetic trunk has not yet been established.


METHODS
We performed a detailed examination of the neck anatomy using 28 cadavers. The pattern of local anesthetic distribution after injection in 2 healthy volunteers was imaged using computed tomographic scan.


RESULTS
The deep cervical plexus was located in the groove between the longus capitis and scalenus medius muscles. The cervical sympathetic trunk was located on the anteromedial surface of the longus capitis. Although anesthetic injected into the longus capitis was confined to the muscle, it infiltrated into neighboring structures including the C2 to C5 roots and sympathetic trunk.


CONCLUSIONS
The longus capitis muscle is a suitable landmark for blocking the cervical plexus and trunk.
Usui
Yosuke
Y
Department of Anatomy (Macro), Dokkyo Medical University, Mibu, Tochigi, Japan.
Kobayashi
Toshiya
T
Kakinuma
Hiroyuki
H
Watanabe
Keisuke
K
Kitajima
Toshimitsu
T
Matsuno
Kenjiro
K
D000779:Anesthetics, Local / Q000008:administration & dosage*; D002102:Cadaver; D002572:Cervical Plexus / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D009334:Neck Muscles / Q000000981:diagnostic imaging / Q000294:innervation*; D009407:Nerve Block / Q000379:methods*; D013564:Sympathetic Nervous System / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional
D000779:Anesthetics, Local