Unlocking the Potential of the Superficial Cervical Plexus Block in Chronic Pain Management: A Narrative Review and Single-Center, Retrospective Case Series

Abstract

Background/Objectives: The anesthetic block of the sensory branches of the superficial cervical plexus renders a specific area of the face, head, and anterior neck insensible and painless. Chronic pain in these areas can be difficult to diagnose and treat. In this report, we briefly review the existing evidence on the topic of the superficial cervical plexus block (SCPB) to set the context for our research. We then share our own clinical experience with the SCPB for managing chronic pain syndromes from both cancerous and non-cancerous etiologies. Methods: We first performed a comprehensive literature search and narrative review of clinical cases and studies that utilized the SCPB as an analgesic technique. We then conducted a retrospective case series of all patients who had received an SCPB at our pain clinic since 2020. Results: Our literature review found only a few cases reported, with most of them focusing on acute painful emergencies and perioperative pain syndromes and only very few addressing chronic pain. In our pain clinic, 14 patients received one or more SCPBs for chronic pain management. In 43% of these cases, the pain was related to cancer. The most common areas of pain corresponded to the regions supplied by the transverse cervical and great auricular nerves. The procedures were uneventful in all cases, and patients rated them as effective and worthwhile 71% of the time. Conclusions: Despite the lack of high-quality studies on SCPBs in pain management, the authors' experience suggests that it is a valid minimally invasive alternative for managing chronic face, head, and neck pain.

Keywords: cancer pain; chronic pain; interventional pain; nerve block; superficial cervical plexus.

Figure 1

Probe placement and ultrasound image with landmarks. (A) The patient is positioned in the lateral decubitus position with the ultrasound probe placed approximately at the middle third of the sternocleidomastoid muscle (SCM). (B) An axial ultrasound scan of the cervical area shows the SCM and levator scapulae muscle (LSM). The white striped line indicates the needle trajectory, with the final dot marking the anatomical target for the injection.