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A Cervical Nerve Block Approach to Improve Safety

¹ Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd., St. Louis, MO 63110.
² Department of Medicine, Tufts/New England Medical Center, Boston, MA.

OBJECTIVE. The objective of this report is to describe a previously unreported technique of selective cervical nerve block, performed from January 1, 2004, to May 19, 2006, in 560 injections, that was designed to allow continual monitoring of injectate passage and verification of needle tip position. We also illustrate faulty needle placement in a cadaveric neck.

CONCLUSION. Using a short connecting tube, contrast material mixed with the final injectate, and fluoroscopy when performing a selective cervical nerve block allows continual monitoring of injectate including where washout of the original testing contrast material actually flows. A true lateral view shows a more dangerous anterior needle tip placement. In addition, performing a test with anesthetic and contrast material, waiting 1.5 minutes before administering the final injectate, and using a water-soluble steroid may provide further safety with selective cervical nerve block.

Keywords: anesthesia • anesthetic • cervical nerve block • CNS • injection technique • spinal injection

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