Cervical plexus block / 대한마취과학회지

Cervical plexus blocks (CPBs) have been used in various head and neck surgeries to provide adequate anesthesia and/or analgesia; however, the block is performed in a narrow space in the region of the neck that contains many sensitive structures, multiple fascial layers, and complicated innervation. Since the intermediate CPB was introduced in addition to superficial and deep CPBs in 2004, there has been some confusion regarding the nomenclature and definition of CPBs, particularly the intermediate CPB. Additionally, as the role of ultrasound in the head and neck region has expanded, CPBs can be performed more safely and accurately under ultrasound guidance. In this review, the authors will describe the methods, including ultrasound-guided techniques, and clinical applications of conventional deep and superficial CPBs; in addition, the authors will discuss the controversial issues regarding intermediate CPBs, including nomenclature and associated potential adverse effects that may often be neglected, focusing on the anatomy of the cervical fascial layers and cervical plexus. Finally, the authors will attempt to refine the classification of CPB methods based on the target compartments, which can be easily identified under ultrasound guidance, with consideration of the effects of each method of CPB.

A study of sectional anatomy with respect to the exposition of brachial plexus in neck area / 中国矫形外科杂志

[Objective]To investagate the anatomic features in the approach to the brachial plexus in neck in order to make the exposure of brachial plexus more convenience and safer.[Method]Neck of six embalmed adult cadavers were made serial sectional specimens,which was observed to identify the border,composition and anatomic relation of fat layer between the superficial and deep layer of cervical fascia in the posterior triangle of neck with the brachial plexus.[Result]There was no branches of superficial cervical plexus in the fat layer between the superficial layer and deep layer of cervical fascia below the middle neck,in which there was no important structures except omohyoid muscle and transverse cervical artery.The deep layer of cervical fascia was dense and was directly superficial to the brachial plexus.[Conclusion]Exposure of brachial plexus in the neck would be more safe and convenience upon the understanding of anatomic relatiowship between cervical fascia and brachial plexus.

A study of the sectional anatomy of the deep cervical fascia / 第三军医大学学报

Objective To provide anatomic proof for the localization in neck operation and clinical diagnosis of infection and tumor infiltration. Methods A total of 15 cadaver heads and necks were sectioned on transverse plan with cryosection. The layers and characteristics of the deep cervical fascia were observed. Results The deep cervical fascia was divided into four layers with the fasciae of the infrahyoid muscles being a single layer. The deep layer of the deep cervical fascia was subdivided into alar fascia and prevertebral fascia. The carotid sheath was composed of all the layers of the deep cervical fascia. Conclusion The model figure of the deep cervical fascia is obtained.