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Brown: Atlas of Regional Anesthesia, 3rd ed., Copyright © 2006 Saunders, An Imprint of Elsevier
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PEARLS

If patients are properly positioned for this block, the superficial block rarely results in problems. If the deep block is carried out and proper palpation is used to limit the amount of tissue between the anesthesiologist’s fingertips and the transverse process, very short needles can help minimize the occurrence of errant deep injections. If a deep cervical plexus block is to be carried out for carotid endarterectomy, the anesthesiologist’s surgical colleagues should be consulted before employing the technique. It is frustrating to find that an adequate deep cervical plexus block does not work for performance of carotid endarterectomy because surgical expectations differ. Superficial cervical plexus block can be used effectively in addition to interscalene block during shoulder surgery to ensure the presence of cutaneous anesthesia when the surgical procedure is started soon after the block.

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